By Institute of Medicine
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Extra info for Addressing the Threat of Drug-Resistant Tuberculosis: A Realistic Assessment of the Challenge: Workshop Summary
WHO. 2008b. Anti-tuberculosis drug resistance in the world, fourth global report by the WHO/IUATLD Global project on anti-tuberculosis drug resistance surveillance. Geneva, Switzerland: WHO. WHO. 2008c. TB/HIV facts. pdf (accessed February 17, 2009). Zintl, P. 2008. Speaker ����������������������������������������������������������������������������� presentation at the Institute of Medicine Workshop on Addressing the Threat of Drug-Resistant Tuberculosis, Washington, DC, November 5. 7 million TB deaths occurred in 2006 alone (WHO, 2008a).
Among the 32 patients, 84 percent had a pair of isolates with discordant patterns, and 16 percent had a pair of isolates with identical patterns. Thus, the researchers concluded that among treated patients, 84 percent of drug resistance was transmitted and 16 percent acquired. Gao stated that new strategies are needed to block the transmission of MDR and XDR TB. , kanamycin, capreomycin, or amikacin), but not both. SOURCE: Gao, 2008. cussed in more detail below). However, implementing effective transmission control in resource-limited settings globally presents major challenges: • • Establishing community-based treatment outside a hospital cur rently is not feasible in some settings because the tradition and infrastructure for community care do not exist.
Without a vaccine and without early, accurate case detection and proper treatment, the MDR/XDR TB epidemic will be driven by transmission. 37 MDR TB TRANSMISSION Number of Patients (in thousands) 500 Estimated 489,000 new MDR TB cases each year 400 300 443 407 Estimated new, untreated cases Non-GLC cases 403 427 407 200 GLC cases 100 0 1 2004 21 16 16 2 2005 36 34 10 12 2007 2008 2 2006 Year FIGURE 3-1 MDR TB burden and patients in treatment. NOTES: The bars represent the number of new MDR TB cases in each year.