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Date: Mon 23 Mar 2009
Source: Agence France-Presse (AFP) [edited]
<http://www.google.com/hostednews/afp/article/ALeqM5ggEeOO8dmSraLn08zh_rczdApbeQ>
Drug-resistant TB on the rise in Asia: WHO
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World health chiefs stressed on Monday [23 Mar 2009] the urgent need
for countries to strengthen their health systems to tackle the spread
of tuberculosis amid the growing threat of drug-resistant TB.
The World Health Organisation's Dr Pieter van Maaren told AFP that
there were 112 000 new cases of drug-resistant TB in China alone in
2007 and figures for 2008 were likely to be similar.
Van Maaren, WHO's Western Pacific regional adviser for TB, said the
Philippines is the 2nd hardest-hit country in the region, with up to
6000 new cases of resistant TB a year.
Viet Nam had an estimated 3000-4000 new cases of multi-drug-resistant
[MDR] TB in 2007 while Cambodia had fewer than 1000 resistant TB
cases, he said ahead of World Stop TB Day on Tuesday [24 Mar 2009] .
Estimates for 2008 are not yet out but van Maaren told AFP that the
rate of new infections will "likely be in the same range" as in 2007.
Exact figures are not available, he said, saying not all of these
cases are diagnosed.
Van Maaren, based at the WHO's Western Pacific headquarters in
Manila, warned drug-resistant TB was more difficult to diagnose and
that drugs to treat it were limited, costly and had more side-effects.
It was "a man-made problem caused by insufficient or inappropriate
treatment, a result of patients stopping treatment before they are
cured," he said.
This can be seen in the Philippines and partly in China, where many
TB patients resorted to "self-medication" without getting the proper
medical advice, allowing the TB bacilli to survive, he added.
In contrast, the rates of drug-resistant TB in Viet Nam and Cambodia
were lower partly because of their good control programmes and also
because powerful anti-TB drugs had only been introduced in those
countries in the past decade, "so the TB bacilli did not have time to
develop resistance."
WHO regional director for the Western Pacific Shin Young-Soo said
despite gains using the WHO-recommended TB control strategy,
effective TB control had been hampered by weaknesses in health
systems such as chronic staff shortages and inadequate resources.
"Our available tools work but they are not enough," said Shin.
Tuberculosis is a contagious lung disease that spreads through the
air, including through coughing and sneezing.
--
Communicated by:
ProMED-MBDS
<promed-mbds@promedmail.org>
[According to the WHO definition, multi-drug resistant (MDR) TB is a
specific form of drug-resistant TB due to a bacillus resistant to at
least isoniazid and rifampicin, the 2 most powerful anti-TB
drugs. In recent years, more drug resistance has been associated
with TB infections and a new classification of extensively
drug-resistant (XDR) TB has been identified. XDR TB is defined as MDR
TB that also is resistant to the most effective seconnd-line
therapeutic drugs used commonly to treat MDR TB: fluoroquinolones and
at least one of 3 injectable second-line drugs used to treat TB
(amikacin, kanamycin, or capreomycin). XDR TB has been identified in
all regions of the world. (For a detailed discussion on XDR TB see
<http://www.cdc.gov/mmwr/preview/mmwrhtml/rr5803a1.htm?s_cid=rr5803a1_e>).
The above newswire is part of a series of newswires issued to raise
international consciousness on TB and the challenges faced in TB
control as part of the World TB day initiatives (24 Mar 2009). The
article gives general background data highlighting the order of
magnitude of TB in China, Viet Nam and Cambodia. More specific data
by country are available on the WHO website, under the 2008 global
report available at
<http://www.who.int/tb/publications/global_report/2008/annex_1_download/en/index.html>.
(the 2009 global report is not as yet available for general viewing,
but should be available shortly at
<http://www.who.int/tb/publications/global_report/en/index.html>).
Data from this report on MBDS member countries are summarized in the
below table.
Country: population (000's) / incidence (all cases/100 000 pop) /
prevalence (all cases/100 000 pop) / percent new cases MDR TB /
percent new cases HIV+
Cambodia: 14 197 / 500 / 665/ 0 / 9.6
China: 1 320 864 / 99 / 201/ 4.0 / 0.3
Laos: N/A
Myanmar: 48 379 / 171 / 169 / 4.0 / 2.6
Thailand: 63 444 / 142 / 98 / 1.7 / 11.0
Viet Nam: 86 206 / 173 / 225 / 2.7 / 5.0
During July 2008, WHO had also issued a warning on MDR TB as a highly
lethal tuberculosis, which could pose a threat to global public
health security (see prior PRO/MBDS posting Tuberculosis, MDR - Asia:
WHO overview 20080722.2215).
Additional background information on this topic is available from WHO
at <http://www.who.int/tb/challenges/mdr/en/> for drug- and
multidrug-resistant tuberculosis (MDR TB), and at
<http://www.who.int/mediacentre/news/notes/2006/np23/en/index.html>
for extensively drug-resistant tuberculosis (XDR TB). - Mods.YMA/MPP]
[see also:
2008
----
Tuberculosis, MDR - Asia: WHO overview 20080722.2215
2007
----
Tuberculosis, XDR - Thailand: RFI 20070613.1922
Tuberculosis - Thailand: RFI 20070522.1634]
...................................yma/mj/mpp
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