Drug Resistant TB Widespread
& Growing Globally
Study Finds
By Gene Emery
BOSTON (Reuters) - Drug-resistant tuberculosis is present almost everywhere in the world and the problem is likely to get worse, researchers said in Thursday's New England Journal of Medicine.
Tuberculosis bacteria slowly eat away lung tissue. There has been a resurgence in TB, in part because it can fester in people whose immune systems have been crippled by the AIDS virus. Only long-term treatment can cure tuberculosis or keep the disease at bay. But when the treatment ends prematurely, the bacteria learn to shrug off the drugs.
To see how common the drug-resistant strains have become, a team of researchers led by Dr. Ariel Pablos-Mendez of the World Health Organization in Geneva used data from about 20,000 people in 35 countries.
On average, they found that among patients who had been treated for TB in the past, 36 percent had developed a strain that was resistant to at least one drug. Among patients with no prior treatment, nearly 10 percent had drug-resistant strains. ``The findings should be of great concern to all those who seek to decrease the global burden of tuberculosis,'' Drs. Dixie E. Snider Jr. and Kenneth G. Castro of the Centers for Disease Control and Prevention said in an editorial in the journal. ``The results of the study suggest that there is a serious threat to global tuberculosis-control efforts, and the findings should be interpreted as a call to action to reduce this threat,'' they said.
Many countries do not have efficient TB-control programs and are unable to afford the drugs needed to treat resistant cases. Thus ``the stage is being set for a substantial increase in the incidence of drug-resistant tuberculosis in many countries,'' Snider and Castro warned.
The percentage of patients whose TB was found to be resistant to at least one drug was 12 percent in the United tates, 7 percent in England and Wales, and 20 percent or more in Russia, Vietnam, Thailand, Sierra Leone, Latvia, Estonia, the Dominican Republic and Botswana.
Canada, Mexico, Germany and Australia were among the countries not surveyed in the study.

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