New WHO report estimates 440,000 MDR-TB cases worldwide in 2008

There were an estimated 440,000 cases of multidrug-resistant tuberculosis (MDR-TB) around the world in 2008 - one-third of which were fatal, according to a new WHO report on drug-resistant TB, the Los Angeles Times reports (Maugh, 3/19). The WHO report, based on data from 2008, found that almost half of all drug-resistant TB cases were in China and India, Reuters reports (Fox, 3/18). 

According to the Associated Press, data was missing from some countries, creating a "gap in the global TB picture." The report said that with current data, it is "impossible at this time to conclude whether the (drug-resistant TB) epidemic worldwide is growing or shrinking," AP reports (Cheng, 3/18).

The report still cautions against the spread of drug-resistant TB and notes that more must be done to achieve global control, the Guardian writes. "Countries face enormous hurdles in accelerating access to diagnostic and treatment services for drug-resistant TB, and previous efforts to address this epidemic have clearly been insufficient," the report said (Boseley, 3/18).

According to a WHO press release, "There is an urgent need to obtain information, particularly from Africa and those high MDR-TB burden countries where data have never been reported: Bangladesh, Belarus, Kyrgyzstan, Pakistan and Nigeria." Based on data from the countries reporting, in some parts of the world, one in four TB cases are MDR, defined as "resistant to at least isoniazid and rifampicin, the most effective anti-TB drugs," according to the release. For instance, 28 percent of newly diagnosed TB patients in one region of northwestern Russia were found to have MDR-TB in 2008, the press release notes. "This is the highest level ever reported to WHO. Previously, the highest recorded level was 22% in Baku City, Azerbaijan, in 2007," it adds (3/18).

Elsewhere - in "Orel, outside Moscow, and Tomsk in Siberia" - the WHO said there had been "a remarkable decline" in MDR-TB over the last five years due to implementation of control efforts, the U.N. News Centre writes. In addition, neighboring "Estonia and Latvia also reversed rates of the disease,"  according to the news service. 

"In Africa, estimates show 69,000 cases [of MDR-TB] emerged, the vast majority of which went undiagnosed," U.N. News Centre writes (3/18). A low percentage of MDR-TB cases are reported in Africa compared with other regions, "due in part to the limited laboratory capacity to conduct drug resistance surveys," according to the WHO press release (3/18).

The AP writes: "Again citing missing data, the agency says 'it has not been possible to conclude whether an overall association between (drug-resistant) TB and HIV epidemics exists.' In Estonia, Latvia and Moldova, WHO said people infected with both HIV and TB were more likely to develop drug-resistant TB. But there is no information from many countries across Africa where the most people with HIV live" (3/18).

The report said of extensively drug-resistant TB (XDR-TB) cases, defined as resistent to first- and second-line drugs: "No official estimates have been made on the number of XDR-TB cases, but there may be around 25,000 a year with most cases fatal," according to the WHO press release (3/18). "Not all countries have the surveillance systems to pick up cases of XDR-TB ... So far, 58 countries have confirmed at least one case of XDR-TB," the Guardian reports (3/18).

"Funding needed for MDR-TB control in 2015 will be 16 times higher than what is currently available in 2010," according to the WHO press release, which highlighted the financial challenges associated with controlling its spread. "There is an urgent need to expand and accelerate in countries access to new, rapid technologies that can diagnose MDR-TB in two days rather than traditional methods which can take up to four months," the release said (3/18).