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Predicted rise in drug-resistant TB

Wednesday May 10th, 2017

Rates of drug-resistant tuberculosis will increase in the four high burden countries - India, the Philippines, Russia, and South Africa - over the next few decades, experts warn today.

This could apply to a third of tuberculosis cases in Russia by 2040, say Dr Aditya Sharma of the US Centers for Disease Control and Prevention, USA, and colleagues in The Lancet Infectious Diseases.

One in ten cases in India and the Philippines, and one in 20 in South Africa are also likely to be drug-resistant. This rise is likely to be due to increased transmission of drug-resistant tuberculosis between people, rather than by strains acquiring resistance to anti-tuberculosis drugs, say the researchers.

Their work used a mathematical model based on figures from the World Health Organisation and surveys to predict how many cases of multidrug-resistant and extensively drug-resistant tuberculosis would develop during 2000 and 2040.

"This study uses a complex model bringing together the best available data from multiple sources in four countries hit hard by the drug-resistant tuberculosis epidemic," explains Dr Sharma. "Our findings show that drug-resistant tuberculosis cases in these countries are expected to rise over the next two decades, and that fewer cases over time will be caused by acquired drug resistance during tuberculosis treatment.

"These findings suggest that person-to-person transmission will become the engine that drives drug-resistant tuberculosis in these countries."

Further research into additional control measures is essential in order to prevent drug-resistant tuberculosis spreading between people, the researchers believe. This could include improving early detection, treatment completion, and tailored treatment based on which drugs the particular strain is susceptible to.

Sharma, A. et al. Estimating the future burden of multidrug-resistant and extensively drug-resistant tuberculosis in India, the Philippines, Russia, and South Africa: a mathematical modelling study. The Lancet Infectious Diseases 10 May 2017 doi: 10.1016/S1473-3099(17)30247-5 [abstract]

Tags: Pharmaceuticals | World Health

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