Tuberculosis Is Fast Becoming a Global Threat

Tuberculosis (TB), a curable disease, is rearing its ugly head again, and because it's becoming resistant to antibiotics, it's rapidly emerging as a major global threat. This warning comes from a report recently released by Doctors Without Borders (Médecins Sans Frontières).

TB is an infectious bacterial disease caused by Mycobacterium tuberculosis; it commonly affects the lungs. It is transmitted from person to person via droplets from the throat and lungs of people with the active respiratory disease.

Infection often causes no symptoms in healthy people, since a healthy immune system acts to “wall off” the bacteria. The symptoms of active TB of the lung are coughing, sometimes with sputum or blood, chest pains, weakness, weight loss, fever, and night sweats. Tuberculosis is typically treatable with a six-month course of antibiotics.

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Deadly Strains Spreading

One-third of the world’s population, around two billion people, is infected with the TB bacterium, but they do not have active TB disease. They have what is often referred to as dormant or "latent" TB. About 10 percent of these people develop the active form of the disease during their lifetime and become sick and potentially infectious.

Every year, around eight million people worldwide fall ill from TB, and 1.3 million people die from the disease.

Drug-resistant TB originally developed because of the improper use of anti-TB medicines. Now, these deadlier TB strains are spreading from person to person, including people who’ve never had TB before. Standard TB drugs can't effectively treat these strains, so doctors have to rely on difficult, long, and expensive treatment regimens that cure only half of patients at best, according to the Doctors Without Borders report. Treatments currently available involve eight months of painful injections, with potentially long-lasting side effects.

TB is airborne and contagious, and now new forms that cannot be cured with standard TB treatments are appearing at an alarming rate. The most widely reported strain is multidrug-resistant TB (MDR-TB), which is resistant to the two most powerful anti-TB drugs. Extensively drug resistant TB (XDR-TB) is even harder to treat.

There are almost half a million new cases of MDR-TB every year, with drug-resistant forms of TB reported in virtually all countries worldwide, according to the report.

As new tools for diagnosing MDR-TB become more widely used, more and more people are being diagnosed, but only 20 percent of people who need it can obtain treatment.  

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Collaborative Approach Needed

Emphasizing that the TB crisis is everybody’s problem and that it requires international cooperation, Sidney Wong, the medical director of Doctors Without Borders, said, “Each year we are diagnosing more patients with drug-resistant TB, but the current treatments aren’t good enough to make a dent in the epidemic. It doesn’t matter where you live; until new short and more effective treatment combinations are found, the odds of surviving this disease today are dismal.”

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Doctors Without Borders urges governments, pharmaceutical companies, and researchers to work together to gather the necessary resources to find improved treatment combinations that are reasonably priced and that can be made readily available in areas where resources are limited. 

In a separate study published in The Lancet, Elize Pietersen of the University of Cape Town's Lung Institute and colleagues studied 107 patients from three provinces in South Africa who had been diagnosed with XDR-TB between August 2002 and February 2008. The researchers concluded that in South Africa, long-term outcomes in patients with XDR-TB are poor.

“Because appropriate long-stay or palliative care facilities are scarce, substantial numbers of patients with XDR tuberculosis who have failed treatment and have positive sputum cultures are being discharged from hospital and are likely to transmit disease into the wider community,” the researchers said.

Echoing the sentiments of Doctors Without Borders, the researchers concluded, “Testing of new combined regimens is needed urgently, and policy makers should implement interventions to minimize disease spread by patients who fail treatment.”

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