Reports highlight global state of TB epidemic, concerns over drug-resistant TB

Increasing rates of multidrug-resistant tuberculosis (MDR-TB) "are hampering world health programs aimed at tackling TB and threaten to wipe out progress made against the disease, scientists said on Friday," Reuters reports (Kelland, 3/18).

In a report published online in the Lancet on Friday, Alimuddin Zumla of University College London Medical School and Stephen Lawn of the University of Cape Town describe the current TB epidemic, factors that may be exacerbating a rise in the number of TB cases worldwide and the ongoing challenges of TB control, the U.K. Press Association reports (3/17).

According to the report, "Tuberculosis results in an estimated 1.7 million deaths each year and the worldwide number of new cases (more than 9 million) is higher than at any other time in history." Low- and middle- income countries are particularly vulnerable to TB, with twenty-two such countries "account[ing] for more than 80% of the active cases in the world," according to the report. In addition, "[d]ue to the devastating effect of HIV on susceptibility to tuberculosis, sub-Saharan Africa has been disproportionately affected and accounts for four of every five cases of HIV-associated tuberculosis" (Lawn/Zumla, 3/18).

"Increasing rates of drug-resistant TB in eastern Europe, Asia, and sub-Saharan Africa now threaten to undermine the gains made by worldwide tuberculosis control programmes," the authors said, UKPA writes (3/17).

The researchers noted that TB "remains a disease of poverty that is inextricably associated with overcrowding and undernutrition" (Lawn/Zumla, 3/18). However, they added that increasing rates of diabetes and smoking in low- and middle-income countries are "increasingly important drivers of the TB epidemic," according to Reuters. "Diabetes raises the risk of developing TB three-fold and smoking increases it two-fold, they said" (3/18).

"Absence of a cheap point of care diagnostic test, the long duration of treatment, lack of an effective vaccine, emergence of drug-resistant tuberculosis, and weak health systems in resource-poor developing countries are all factors that continue to hamper progress towards achieving control of tuberculosis worldwide," Zumla and Lawn write (3/18).

They "warned that growing research to secure treatment and prevention methods needed to be matched by the political commitment to adequately fund the World Health Organisation's aim of halting TB," UKPA adds (3/17).

Experts Warn Of Rise Of Drug-Resistant TB In Europe

Also on Friday, the WHO and European Center for Disease Prevention and Control (ECDC) released a report warning about an increase in MDR-TB cases in Europe "and the persistence of TB among children," the Guardian's "Global Health Blog" reports (Boseley, 3/18).

"According to data from the WHO's European office, reported rates of TB have been falling in Europe since 2005 with a regional average of 36.8 notifications per 100,000 population in 2009," Reuters writes. "But notification rates of newly detected and relapsed TB cases in 18 high-priority countries remain almost eight times higher than in the rest of the region, the WHO data show," according to the news service.

"Vulnerable populations, including children, still do not have ready access to quality and timely diagnosis and treatment," the WHO-ECDC report stated, the news service writes. "This remains a matter of urgency given the high prevalence of multi- and extensively drug-resistant TB in the region," the report notes (3/18).

"Global Health Blog" notes that the WHO regional office is working with partners to create a "five-year plan" to tackle the issues identified in the report (3/18).