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Extra resources for Addressing the Threat of Drug-Resistant Tuberculosis: A Realistic Assessment of the Challenge: Workshop Summary

Sample text

Second, because about half of these patients had never before been treated for TB, and 85 percent had a genetically similar strain, resistance was likely transmitted rather than acquired. The progression of XDR TB from June 2006 to 2007 is depicted in Figure 3-2, which shows facilities within KwaZulu-Natal Province where at least one XDR TB case was described or diagnosed. There were 6 such  A compensatory mutation occurs when the fitness loss caused by one mutation is corrected by that mutation’s epistatic interaction with a second mutation at a different location within the genome.

Although coinfection with HIV and MDR TB has received particular attention in Africa—especially in Tugela Ferry—it is also a threat in Eastern Europe. 7 million of its residents. Similar data exist for Latvia. , 2008).  The remainder are probably being treated with drugs and programs of unknown quality, a particular concern in Eastern Europe. Summary Nunn summarized his remarks by noting that drug-resistant patients in 2004 were resistant to significantly more drugs than they were in 1994. MDR TB is increasing in several countries and decreasing in others.

This rural area with a traditional Zulu population has an extraordinarily high incidence of TB—more than 1,000 per 100,000 population. The incidence of MDR TB, by Friedland’s calculation, is 100 per 100,000 population, much higher even than nonresistant TB in most parts of the world. Among MDR and XDR TB patients, the rate of HIV coinfection is greater than 90 percent. , 2006), many thought it was an outbreak that would dissipate over time. As indicated in Figure 2-6, however, from 2005 to 2007, both MDR and XDR TB cases continued to increase, and the ratio of XDR to MDR remained very high.

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