WHO says drug-resistant TB spreads fast

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WHO says drug-resistant TB spreads fast

By MARIA CHENG, AP Medical Writer 1 hour, 22 minutes ago

LONDON - Drug-resistant tuberculosis is spreading even faster than

medical experts had feared, the World Health Organization warned in

report issued Tuesday. The rate of TB patients infected with the

drug-resistant strain topped 20 percent in some countries, the highest

ever recorded, the U.N. agency said.

" Ten years ago, it would have been unthinkable to see rates like

this, " said Dr. Raviglione, director of WHO's " Stop TB "

department. " This demonstrates what happens when you keep making

mistakes in TB treatment. "

Though the report is the largest survey of drug-resistant TB, based on

information collected between 2002 and 2006, there are still major

gaps: Data were only available from about half of the world's countries.

In Africa, where experts are particularly worried about a lethal

collision between TB and AIDS, only six countries provided information.

" We really don't know what the situation is in Africa, " Raviglione

said. " If multi-drug resistant TB has penetrated Africa and coincides

with AIDS, there's bound to be a disaster. "

Raviglione said it was likely that patients — and even entire

outbreaks of drug-resistant TB — were being missed.

Experts also worry about the spread of XDR-TB, or extensively

drug-resistant TB, a strain virtually untreatable in poor countries.

When an XDR-TB outbreak was identified in AIDS patients in South

Africa in 2006, it killed nearly every patient within weeks. WHO's

report said XDR-TB has now been found in 45 countries.

Globally, there are about 500,000 new cases of drug-resistant TB every

year, about 5 percent of the 9 million new TB cases. In the United

States, 1.2 percent of TB cases were multi-drug resistant. Of those,

1.9 percent were extensively drug-resistant.

The highest rates of drug-resistant TB were in eastern Europe. Nearly

a quarter of all TB cases in Baku, Azerbaijan, were drug-resistant,

followed by about 20 percent in Moldova and 16 percent in Donetsk,

Ukraine, WHO said.

High rates of drug-resistant TB were also found in China and India,

the world's two most populous nations that together are home to half

the world's cases.

Drug-resistant TB arises when primary TB treatment is poor. Countries

with strong treatment programs, like the U.S. and other Western

nations, should theoretically have very little drug-resistant TB.

That is not the case in China, however, where the government says 94

percent of TB patients complete their first TB treatment.

" There's a huge, gross discrepancy there if they are then reporting 25

percent of the world's multi-drug resistant TB cases, " said Mark

Harrington, executive director of Treatment Action Group, a public

health think tank. " They are clearly nurturing a multi-drug resistant

TB epidemic and failing to report XDR-TB at all. "

With growing numbers of drug-resistant TB patients, there is concern

some national health systems will soon be overwhelmed.

" We are totally off track right now, " said Dr. Tido von

Schoen-Angerer, executive director of Medecins Sans Frontiere's

Campaign for Access to Essential Medicines. He said only 30,000

multi-drug TB resistant patients were treated last year.

Experts said new drugs are needed if the outbreak is to be curbed,

along with new diagnostic tests to identify drug-resistant TB strains

faster — current tests take about a month for results.

WHO said a new diagnostic test able to provide results within a day is

being tried in South Africa and Lesotho. If successful, the test could

be introduced across Africa in a few months, though new labs would be

needed to run the tests.

" Multi-drug resistant TB is a threat to every person on the planet, "

Harrington said. " It's not like HIV, where you are only infected

through specific actions. TB is a threat to every person who takes a

train or a plane. "

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