Posted on 12/16/2006 7:37:58 AM PST by blam
Drug resistant TB 'more severe'
Patients must complete a full course of drugs to cure TB
The problem of multidrug-resistant tuberculosis may be even more severe than previously thought, experts warn. A survey of 79 countries by the World Health Organization published in the Lancet found TB drug resistance in virtually every one.
Particularly high levels of resistance were seen in regions of the former Soviet Union and parts of China.
About a third of the world's population is infected with the TB bug, with 8.9 million developing TB each year.
In 2004, the respiratory disease caused 1.7 million deaths worldwide.
MULTIDRUG-RESISTANT TB
* Kazakhstan: 14.2% of new cases
* Tomsk, Russia: 13.7%
* Uzbekistan: 13.8%
* Estonia: 12.2%
* Liaoning province, China: 10.4%
* Lithuania: 9.4%
* Latvia: 9.3%
* Henan province, China: 7.8%
Anti-microbial drugs have proved very effective at treating TB.
But experts believe their misuse has given the bacteria too much chance to evolve new defences which render the drugs less effective.
The biggest problem is patients failing to complete a full course of the drugs.
Even though symptoms might have disappeared, small amounts of the bacteria may remain, and are capable of mutating.
Multidrug-resistant TB strains are those that are resistant to at least the two most potent drugs, isoniazid and rifampicin.
More dangerous strains
Scientists have recently reported an even more worrying from - extensive drug-resistant TB (XDR-TB) - which has been found among people with HIV in South Africa.
The latest study was carried out for the Global Project on Anti-Tuberculosis Drug Resistance Surveillance, which was set up in 1994.
From their analysis, the WHO team estimated there were 424,000 cases of multidrug-resistant TB world-wide in 2004.
China, India and Russia accounted for half of these cases.
The researchers believe about 1% of new cases of TB are caused by multidrug-resistant strains. However, in eight countries, including Kazakhstan and Latvia, the figure was above 6.5%.
Three countries - Andorra, Iceland and Malta - had no cases of resistance to first-line drugs, while in the United States, Hong Kong and Cuba, the cases of MDR TB showed a decline.
Lead researcher Dr Mario Raviglione said: "The findings of the Global Project emphasise the importance of implementing sound tuberculosis control activities to prevent further creation of MDR tuberculosis, and the necessity of mainstreaming high-quality treatment for MDR tuberculosis into routine tuberculosis control programmes.
"Otherwise XDR-TB is bound to keep emerging as a fatal variant of TB, especially in high HIV prevalence settings."
Cases of tuberculosis (TB) in England, Wales and Northern Ireland rose by 10.8% in 2005, figures show.
Lack of funds
Professor Peter Davies, of the organisation TB Alert, said TB - and in particular multidrug resistant strains of the disease - was a bigger problem than people had expected it to be.
He said around US$500m had been committed globally to the search for new drugs - but this was only around half the amount a commercial pharmaceutical company spent on developing one product.
"We are simply not getting the funding for new drugs and vaccines that is required," he said.
"New drugs are being discovered, but there is no money to put them through randomised clinical trials.
"We have known this is a problem for 20 years, but we have not been serious about controlling TB."
Obviously since there's more and more cases now days.
Why doesn't anyone use bacteriophages to treat bacterial infections?
...and thanks to the 20 million illegals here, we will soon be able to add the United States to that list.
Thank you, Mr. Bush, Mr. Rove, Mr. Clinton, et al.
Excellent question.
Human nature bites itself in the keister sometimes. You take 75% of the drugs, you start to feel fine, you don't take the rest of the pills...
http://www.eagleforum.org/column/2005/aug05/05-08-31.html
Dr. Madeleine Cosman, Esq. is a national authority on the diseases brought into our country by illegal aliens, who of course are not given health examinations required of all legal immigrants. Apparently, some people would like to prevent her from presenting her message to the public.
Dr. Cosman, who is both a Ph.D. and a lawyer, described the infectious diseases now spreading across the United States. Contagious diseases that our country wiped out years ago, such as malaria, polio, tuberculosis, and hepatitis, and rare diseases of Third World poverty such as leprosy, Chagas Disease, and Dengue Fever, are coming in.
The Centers for Disease Control reported 38,291 California cases of tuberculosis that included Multiple Drug Resistant Tuberculosis, which is 60 percent fatal and for which treatment costs $200,000 to $1,200,000 per patient. Illegal aliens are also bringing in syphilis and gonorrhea.
Now! Now! Now! Our little Diverse one's are merely transmitting the diseases Americans will not transmit.
"Just one more thing we have to thank our junkies and illegal aliens for."
I remember the days when you used to have to have a health card to work in restaurants. They checked you for TB.
Bring back the concept of quarantine,I say.
You are right, I've forgotten that. I wonder why they did away with it. The ACLU probably decided the test was "discriminatory".
gay dudes are walking TB factories --un-PC, isn't it? You'll never hear it, anywhere else...!
Actually TB was never eradicated, even in the US. ("Eradicated," in epidemiological terms, means having an incidence rate of one case per million population. We've never come close to hitting that mark for TB.) The US started keeping TB statistics in 1953, and the rates have been dropping every year since, except for a brief period in the late 1980s going into the early 1990s when we had an epidemic. TB cases and rates are the lowest they've ever been in the US now. While Mexico is the leading source of TB cases from outside the US, more cases originate inside the US than are imported from Mexico. It was only a few years ago that aliens made up the majority of TB cases in the US. The leading sources of TB from outside the US are now Mexico, the Philippines, Viet Nam, India and China.
"The leading sources of TB from outside the US are now Mexico..."
Exactly. And the logical question, then, becomes "how long will it take before the US is the leading source of TB for itself...?
You're exactly right. Today's standard TB drug regimen--2 months of Rifampin, Isoniazid, Pyrazinamide and Ethambutol, followed by 4 months of Isoniazid and Rifampin--takes 6 months, but symptoms are gone in 2 or 3 weeks, meaning it's not easy to be diligent in taking all the drugs for the entire duration of treatment. This is especially the case considering that the drugs can create unpleasant side effects themselves. Unfortunately, it doesn't take much for the TB bacillus to build up resistance to the drugs. That's why the standard means of treating TB calls for a health worker to watch the patient take every single dose of medicine (called "directly observed therapy," or DOT)--to ensure that the treatment is administered properly and in a way that minimizes or eliminates the rise of drug resistance. Also, the last TB drug to be developed, Rifampin, came on the market 40 years ago, and pharmaceutical companies aren't exactly battling each other to come out with the newest TB drug (regardless of what "The Constant Gardener" portrays). This means that TB drugs are precious. Do a google search for XDR-TB and you'll find that we may be losing the battle against TB drug resistance, however.
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