Resistance to drugs may derail fight against TB

RESISTANCE to anti-tuberculosis (TB) drugs is threatening to derail efforts to eradicate the disease globally.

Ahead of World TB Day today‚ a new report in UK medical journal The Lancet reveals that one in five cases of TB are now resistant to at least one major TB drug and about 5% of all cases are either multi-drug-resistant (MDR) or extensively drug-resistant (XDR).

According to the report‚ TB kills more people each year than any other infectious disease‚ including HIV/Aids. In 2015 TB killed about 1.8 million people.

Six countries account for 60% of the TB worldwide – India‚ Indonesia‚ China‚ Nigeria‚ Pakistan and South Africa.

In most regions drug-resistant TB is now predominantly caused by transmission‚ with an estimated 95.9% of new cases due to drug-resistant bacteria spreading from one person to the next.

Dr Nesri Padayatchi‚ deputy director of the Centre for the Aids Programme of Research in South Africa and an expert on drug-resistant TB‚ said treatment success for XDR-TB locally varied from 16 to 22% and almost half of patients died despite treatment.

“The concurrent epidemic of HIV‚ with rates of co-infection exceeding 70%‚ further exacerbates this TB epidemic.

“Previously, drug-resistant TB in South Africa was considered to be caused largely due to poor treatment adherence or inadequate treatment‚ but … in KwaZulu-Natal‚ transmission of XDR-TB may also be direct.”

University of Cape Town pulmonologist Professor Keertan Dheda said in the Lancet: “Resistance to anti-TB drugs is a global problem that threatens to derail efforts to eradicate the disease. Even when the drugs work‚ TB is difficult to cure and requires months of treatment with a cocktail of drugs. With resistance treatment can take years and the drugs have unpleasant and sometimes serious side-effects.” Dheda said cure rates are poor and people can remain infectious.

“Improved diagnostic tests are on the horizon‚ but we need huge efforts to increase their accuracy‚ use them for active case finding ... and make them available in low-income countries ... to inform treatment decisions.” — TMG those