Multidrug-resistant and extensively drug-resistant tuberculosis: a threat to global control of tuberculosis

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dc.contributor.authorGandhi N.R.
dc.contributor.authorNunn P.
dc.contributor.authorDheda K.
dc.contributor.authorSchaaf H.S.
dc.contributor.authorZignol M.
dc.contributor.authorvan Soolingen D.
dc.contributor.authorJensen P.
dc.contributor.authorBayona J.
dc.date.accessioned2011-05-15T15:58:07Z
dc.date.available2011-05-15T15:58:07Z
dc.date.issued2010
dc.description.abstractAlthough progress has been made to reduce global incidence of drug-susceptible tuberculosis, the emergence of multidrug-resistant (MDR) and extensively drug-resistant (XDR) tuberculosis during the past decade threatens to undermine these advances. However, countries are responding far too slowly. Of the estimated 440 000 cases of MDR tuberculosis that occurred in 2008, only 7% were identified and reported to WHO. Of these cases, only a fifth were treated according to WHO standards. Although treatment of MDR and XDR tuberculosis is possible with currently available diagnostic techniques and drugs, the treatment course is substantially more costly and laborious than for drug-susceptible tuberculosis, with higher rates of treatment failure and mortality. Nonetheless, a few countries provide examples of how existing technologies can be used to reverse the epidemic of MDR tuberculosis within a decade. Major improvements in laboratory capacity, infection control, performance of tuberculosis control programmes, and treatment regimens for both drug-susceptible and drug-resistant disease will be needed, together with a massive scale-up in diagnosis and treatment of MDR and XDR tuberculosis to prevent drug-resistant strains from becoming the dominant form of tuberculosis. New diagnostic tests and drugs are likely to become available during the next few years and should accelerate control of MDR and XDR tuberculosis. Equally important, especially in the highest-burden countries of India, China, and Russia, will be a commitment to tuberculosis control including improvements in national policies and health systems that remove financial barriers to treatment, encourage rational drug use, and create the infrastructure necessary to manage MDR tuberculosis on a national scale. © 2010 Elsevier Ltd. All rights reserved.
dc.description.versionReview
dc.identifier.citationThe Lancet
dc.identifier.citation375
dc.identifier.citation9728
dc.identifier.issn1406736
dc.identifier.other10.1016/S0140-6736(10)60410-2
dc.identifier.urihttp://hdl.handle.net/10019.1/10782
dc.subjectclavulanic acid
dc.subjectisoniazid
dc.subjectlinezolid
dc.subjectmeropenem
dc.subjectquinoline derived antiinfective agent
dc.subjectrifampicin
dc.subjecttuberculostatic agent
dc.subjectacquired immune deficiency syndrome
dc.subjectantibiotic sensitivity
dc.subjectChina
dc.subjectdiagnostic test
dc.subjectdrug treatment failure
dc.subjectextensively drug resistant tuberculosis
dc.subjectgene mutation
dc.subjecthealth care financing
dc.subjecthealth care policy
dc.subjecthuman
dc.subjectHuman immunodeficiency virus infection
dc.subjectIndia
dc.subjectmedical ethics
dc.subjectmortality
dc.subjectmultidrug resistant tuberculosis
dc.subjectMycobacterium tuberculosis
dc.subjectpriority journal
dc.subjectpublic health
dc.subjectreview
dc.subjectRussian Federation
dc.subjectshort course therapy
dc.subjecttuberculosis
dc.subjecttuberculosis control
dc.subjectworld health organization
dc.subjectAntitubercular Agents
dc.subjectDrug Resistance, Bacterial
dc.subjectExtensively Drug-Resistant Tuberculosis
dc.subjectHIV Infections
dc.subjectHumans
dc.subjectIncidence
dc.subjectTuberculosis, Multidrug-Resistant
dc.subjectTuberculosis, Pulmonary
dc.titleMultidrug-resistant and extensively drug-resistant tuberculosis: a threat to global control of tuberculosis
dc.typeReview
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