Drug-Resistant TB rate reaches record levels

The incidences of the drug-resistant version of the world's deadliest curable infectious disease, tuberculosis, have reached alarming levels around the world, particularly in parts of the former Soviet Union, federal health officials reported Tuesday.

While releasing findings from the largest global survey of the problem, the World Health Organization (WHO) cautioned yesterday that drug-resistant tuberculosis cases in parts of the former Soviet Union have reached the highest rates ever recorded globally.

The number of tuberculosis outbreaks in the former Soviet Union could soar even higher, spreading the potentially fatal bacterial disease elsewhere, WHO warned.

The survey, first of its kind to be released in the past 4 years, looked at 90,000 tuberculosis patients in 81 countries between 2002 and 2006, and recorded the highest rates of multi-drug resistant tuberculosis (MDR-TB) ever found.

The highest rate was recorded in Baku, the capital of Azerbaijan, where 22.3 percent of new tuberculosis cases were resistant to the standard anti-tuberculosis drug regimen during the survey period.

The rate, which exceeded the previous high of 14.2 percent, in Kazakhstan, was not thought to be possible in the 1990s. "The speculation was that it wouldn't go over 10 percent," said Mario Raviglione, the head of WHO's tuberculosis department.

Additional outbreaks of the drug resistant strain of tuberculosis were reported in 14 regions, including the former Soviet republic of Georgia and the Inner Mongolia and Heilongjiang regions of China, where the rates are about 7.25 percent, Armenia (9 percent); Latvia (11 percent); Tashkent, Uzbekistan (15 percent); and the Donetsk region of Ukraine (16 percent).

“We are seeing levels of multidrug-resistant TB that we never expected — 20 percent is a very high level,” Dr. Raviglione said.

Experts also worry about the spread of XDR-TB, or extensively drug-resistant TB, a virtually untreatable form of the respiratory disease. The surge in the XDR-TB presents significant challenges to efforts to bring the global epidemic of ordinary TB under control, WHO said.

Tuberculosis or TB is an airborne bacillus caused by a bacterium called Mycobacterium tuberculosis that spreads through coughing or sneezing. It mainly affects the lung (80%) but can also affect most of other parts of the body except hair and nails.

The other body parts which can come in grip of the disease are lymph nodes, gastro intestinal tract, genito-urinary tract, coverings of the brain (called meninges), linings of the lungs(pleura), heart(pericardium), brain, bones, joints, skin, eyes and other organs.

Multidrug resistant TB (MDR TB) is a form of TB that is resistant to at least two first line therapies – isoniazid and rifampin, while extensively drug-resistant TB (XDR TB), which has been reported in 45 countries, develops from MDR-TB, and is resistant to at least isoniazid and rifampin among the first-line anti-TB drugs and among second-line drugs.

The latest report suggests that the cause of the surging outbreaks is partially due to the country’s failure to invest into equipment, staff and laboratories to detect the disease earlier in the process.

In addition, health authorities in many countries have not been providing the necessary drugs to patients or ensuring proper follow up to treatment to those that are infected with the disease. According to the WHO, about one in every 20 new cases of tuberculosis worldwide is now resistant to the first line of drugs.

About 9 million new tuberculosis cases are reported each year around the world and about 1.6 million people die from the disease that usually attacks the lungs, and is second only to AIDS in deaths caused by infectious illness.