Only rapid and internationally concerted action, combined with intensified research efforts and the support of the affected nations, will be able to prevent the development of a situation that will no longer be manageable even with 21st-century technology.
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Continuing Medical Education Drug-Resistant Tuberculosis A Worldwide Epidemic Poses a New Challenge 1Deutsches Zentralkomitee zur Bekämpfung der Tuberkulose, Berlin *Deutsches Zentralkomitee zur Bekämpfung der Tuberkulose, Stralauer Platz 34, 10243 Berlin, Germany, Email: rloddenkemper@dzk-tuberkulose.de Received May 19, 2009; Accepted July 15, 2009. Abstract Background Although the incidence of tuberculosis (TB) in Germany is now declining, the world as a whole faces the threat of a catastrophe that will also affect the industrialized nations. The main reason, aside from TB/HIV co-infection, is the increase of resistant TB strains. The situation is already serious because of the spread of multidrug-resistant TB, i.e., TB that is resistant to the two most important antituberculous drugs, and is being further aggravated by resistance to second-line drugs as well. Method Selective review of the literature. Results There are an estimated half a million cases of multidrug-resistant TB worldwide, and so-called extensively resistant TB (XDR-TB), with additional resistance to defined second-line drugs, is now prevalent in more than 45 countries. An accurate assessment of the situation is hampered by a widespread lack of laboratory capacity and/or proper surveillance. The problem is mainly due to inappropriate treatment, which may have many causes, but is theoretically avoidable. Aside from programmatic weaknesses, a lack of diagnostic and therapeutic tools causes difficulties in many countries. Discussion Only rapid and internationally concerted action, combined with intensified research efforts and the support of the affected nations, will be able to prevent the development of a situation that will no longer be manageable even with 21st-century technology. | |
