Drug resistant TB rife in China

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Drug resistant TB rife in China Thu Dec 11, 1:34 am ET

HONG KONG (Reuters) – Levels of drug-resistant tuberculosis (TB) in

China are nearly twice the global average and almost 10 percent of

cases are resistant to the most effective first-line drugs, a study

has shown.

China has an estimated 4.5 million cases of people with TB, the

second-largest number of TB cases in the world after India and is

struggling with high levels of drug-resistant TB, which is costly and

difficult to treat.

In a survey involving 10 provinces between 1996 and 2004, researchers

found that multi-drug resistant (MDR) TB made up 9.3 percent of all

cases, 5.4 percent of new cases and 25.6 percent of previously treated

cases.

All three figures were markedly higher than global MDR-TB figures

which stand at 4.8 percent for all cases, 3.1 percent for new cases

and 19.3 percent for previously treated cases, the researchers wrote

in the journal BMC Infectious Diseases.

Regular TB requires a six to 12 months course of treatment, but many

patients tend to give up because of side effects or a careless attitude.

But this comes with a serious risk, as they may develop drug

resistance and require stronger drugs the next time round, which may

be too expensive or simply unavailable.

MDR-TB, which is defined as resistance to two of the most potent

anti-TB drugs, takes two years to treat and is costly. Toxic and less

effective second-line drugs are used and infected patients are less

likely to survive.

With a good TB control program, the proportion of previously treated

patients among all TB patients should be low.

But the study found that the proportion of previously treated patients

in China was around 20 percent, compared to a global average of 11

percent.

" Many possible explanations for the development of drug resistance in

China exist, and different explanations may prevail in different areas

of this vast country, " the researchers wrote.

" These include the inadequate use of anti-TB drugs in public

hospitals, lack of supervision of treatment, poor drug-management and

absence of infection control measures in hospitals. "

" Also, availability of anti-TB drugs without a prescription in some

areas of China in the past may have contributed to the development of

drug resistance, " they said.

http://news./s/nm/20081211/hl_nm/us_tuberculosis_china_1