Drug resistant tuberculosis soars in eastern Europe
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《英国医生杂志》
Multidrug resistant tuberculosis in parts of eastern Europe and the former Soviet Union is 10 times as common as in most parts of the world, a new report from the World Health Organization said this week.
The report, which is WHO's third on drug resistant tuberculosis, contains new data obtained from the WHO/IUATLD (International Union Against Tuberculosis and Lung Disease) Global Project on Anti-Tuberculosis Drug Resistance Surveillance.
Speaking at the report's launch in London this week, Dr Paul Nunn, coordinator of tuberculosis, HIV, and drug resistance at the Stop TB department of WHO, said: "We see about nine million cases worldwide every year and about two million deaths."
He said: "This report . . . covers 77 geographic settings, most of which are countries—except in certain instances like China, where several settings are in one country. Thirty nine of the settings are new, and 67 657 cases were tested.
"It was found that multidrug resistance in parts of eastern Europe and the former Soviet Union was 10 times what it was in the rest of the world, with rates as high as 14% in new patients."
On the link between tuberculosis and HIV, Dr Nunn said: "In the former Soviet Union, about 1.5 million people are HIV positive, and the rate of rise is faster than ever before."
He added: "We are calling for expansion of DOTS , increased investment in DOTS-Plus, increased investment in laboratory networks, and increased investment in drug resistance surveillance. This report covers only 20% of the world's population."
Dr Mario Raviglione, director of the Stop TB department of WHO, said: "The best way to control TB is the DOTS approach." He said: "TB drug resistance is an urgent public health issue . . . It is in the interest of every country to support rapid scale-up of TB control if we are to overcome multidrug resistant TB. Passport control will not halt drug resistance; investment in global TB prevention will."
Dr Paul Sommerfield, founder and chairman of TB Alert UK, said: "The prevalence of multidrug resistant TB in the UK now is between 1% and 1.5%." However, he added: "The most important intervention is a worldwide effort."
Multidrug resistant tuberculosis occurs when patients no longer benefit from treatment with the two main drugs for tuberculosis, isoniazid and rifampicin. It can arise due to poor adherence to treatment, inappropriate prescription, irregular drug supply, or poor drug quality. It can be fatal if untreated, and the cost of treatment is 100 times more than that for treating non-resistant tuberculosis. Treatment takes the form of second line drugs such as cycloserine and capreomycin. In view of the cost of these drugs, WHO has set up a "green light" committee that facilitates access to these drugs at prices as low as 99% under the market price.(BMJ Chibuzo Odigwe)
The report, which is WHO's third on drug resistant tuberculosis, contains new data obtained from the WHO/IUATLD (International Union Against Tuberculosis and Lung Disease) Global Project on Anti-Tuberculosis Drug Resistance Surveillance.
Speaking at the report's launch in London this week, Dr Paul Nunn, coordinator of tuberculosis, HIV, and drug resistance at the Stop TB department of WHO, said: "We see about nine million cases worldwide every year and about two million deaths."
He said: "This report . . . covers 77 geographic settings, most of which are countries—except in certain instances like China, where several settings are in one country. Thirty nine of the settings are new, and 67 657 cases were tested.
"It was found that multidrug resistance in parts of eastern Europe and the former Soviet Union was 10 times what it was in the rest of the world, with rates as high as 14% in new patients."
On the link between tuberculosis and HIV, Dr Nunn said: "In the former Soviet Union, about 1.5 million people are HIV positive, and the rate of rise is faster than ever before."
He added: "We are calling for expansion of DOTS , increased investment in DOTS-Plus, increased investment in laboratory networks, and increased investment in drug resistance surveillance. This report covers only 20% of the world's population."
Dr Mario Raviglione, director of the Stop TB department of WHO, said: "The best way to control TB is the DOTS approach." He said: "TB drug resistance is an urgent public health issue . . . It is in the interest of every country to support rapid scale-up of TB control if we are to overcome multidrug resistant TB. Passport control will not halt drug resistance; investment in global TB prevention will."
Dr Paul Sommerfield, founder and chairman of TB Alert UK, said: "The prevalence of multidrug resistant TB in the UK now is between 1% and 1.5%." However, he added: "The most important intervention is a worldwide effort."
Multidrug resistant tuberculosis occurs when patients no longer benefit from treatment with the two main drugs for tuberculosis, isoniazid and rifampicin. It can arise due to poor adherence to treatment, inappropriate prescription, irregular drug supply, or poor drug quality. It can be fatal if untreated, and the cost of treatment is 100 times more than that for treating non-resistant tuberculosis. Treatment takes the form of second line drugs such as cycloserine and capreomycin. In view of the cost of these drugs, WHO has set up a "green light" committee that facilitates access to these drugs at prices as low as 99% under the market price.(BMJ Chibuzo Odigwe)