Efforts to thwart tuberculosis are being hampered by increased rates in drug resistance and other risk factors such as smoking and diabetes, experts warn today.
Writing in The Lancet, Professor Alimuddin Zumla, of University College London Medical School, UK, and Dr Stephen Lawn, from the University of Cape Town, South Africa, point to a number of factors affecting the treatment of the disease that causes about 1.7 million deaths a year.
Their article – a Seminar Online First – says that with the number of cases now more than nine million every year, TB is higher than at any other time in history. Twenty-two low-income and middle-income countries account for more than 80 per cent of the active cases in the world.
HIV increases the risk of developing TB by 20-fold, which has resulted in sub-Saharan Africa being disproportionately affected, accounting for four out of every five cases of HIV-associated tuberculosis.
"Increasing rates of drug-resistant TB in eastern Europe, Asia, and sub-Saharan Africa now threaten to undermine the gains made by worldwide tuberculosis control programmes,” write the authors.
There are other factors that are affecting the rates of TB, they say, including the prevalence of diabetes, which increases risk three-fold, and the very high rates of tobacco consumption in low- and middle-income countries, which increases risk two-fold.
Other risk factors include cancers, vitamin D deficiency, alcoholism, indoor air pollution, long-term kidney failure, genetic variations, and use of corticosteroids and tumour necrosis factor (TNF) drugs to treat conditions such as rheumatoid arthritis.
“Absence of a cheap point-of-care diagnostic test, the long duration of treatment, lack of an effective vaccine, emergence of drug-resistant TB, and weak health systems in resource-poor developing countries are all factors that continue to hamper progress towards achieving control of TB worldwide,” they write.
“Despite this, there is growing momentum in basic and applied research activity that is starting to yield new diagnostic treatment, and prevention methods, and now provide grounds for optimism.”
* Meanwhile, experts from 12 countries are to gather for a conference at the Institute of Tropical Medicine in Antwerp, The Netherlands, to discuss the fight against TB.
The conference takes place on March 22, two days before World TB Day.
Delegates will look at the urgent need for the development of new tools urgently to prevent, treat and diagnose the disease.
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