Emergence and treatment of multidrug resistant (MDR) and extensively drug-resistant (XDR) tuberculosis in South Africa
dc.contributor.author | Streicher E.M. | |
dc.contributor.author | Muller B. | |
dc.contributor.author | Chihota V. | |
dc.contributor.author | Mlambo C. | |
dc.contributor.author | Tait M. | |
dc.contributor.author | Pillay M. | |
dc.contributor.author | Trollip A. | |
dc.contributor.author | Hoek K.G.P. | |
dc.contributor.author | Sirgel F.A. | |
dc.contributor.author | Gey van Pittius N.C. | |
dc.contributor.author | van Helden P.D. | |
dc.contributor.author | Victor T.C. | |
dc.contributor.author | Warren R.M. | |
dc.date.accessioned | 2011-10-13T16:58:41Z | |
dc.date.available | 2011-10-13T16:58:41Z | |
dc.date.issued | 2011-10-13 | |
dc.description.abstract | Drug resistant tuberculosis (TB) has reached alarming proportions in South Africa, draining valuable resources that are needed to fight drug susceptible TB. It is currently estimated that 9.6% of all TB cases have multi-drug resistant (MDR)-TB, thereby ranking South Africa as one of the highest MDR-TB burden countries in the world. Molecular epidemiological studies have demonstrated the complexity of the epidemic and have clearly shown that the epidemic is driven by transmission as a consequence of low cases detection and diagnostic delay. The latter has in turn fueled the amplification of drug resistance, ultimately leading to the emergence of extensively drug resistant (XDR)-TB. Despite the introduction of new drugs to combat this scourge, culture conversion rates for XDR-TB remain below 20%. Failure to achieve cure may be explained from DNA sequencing results which have demonstrated mutations in 7 genes encoding resistance to at least 8 anti-TB drugs. This review shows how molecular epidemiology has provided novel insights into the MDR-TB epidemic in South Africa and thereby has highlighted the challenges that need to be addressed regarding the diagnosis and treatment of MDR-TB. An important step towards for curbing this epidemic will be collaboration between clinicians, laboratories and researchers to establish scientific knowledge and medical expertise to more efficiently guide public health policy. | |
dc.description.version | Article in Press | |
dc.identifier.citation | Infection, Genetics and Evolution, 12, 4, 686-694 | |
dc.identifier.citation | http://www.scopus.com/inward/record.url?eid=2-s2.0-80052037546&partnerID=40&md5=7600850097eb79f89e1c047efdac59cd | |
dc.identifier.issn | 15671348 | |
dc.identifier.other | 10.1016/j.meegid.2011.07.019 | |
dc.identifier.uri | http://hdl.handle.net/10019.1/16820 | |
dc.subject | Drug resistance | |
dc.subject | Evolution | |
dc.subject | MDR-TB | |
dc.subject | Surveillance | |
dc.subject | XDR-TB | |
dc.title | Emergence and treatment of multidrug resistant (MDR) and extensively drug-resistant (XDR) tuberculosis in South Africa | |
dc.type | Article |