Drug-resistant tuberculosis: time for visionary political leadership.
نویسندگان
چکیده
Two decades ago, WHO declared tuberculosis a global emergency, and invested in the highly cost-effective directly observed treatment short-course programme to control the epidemic. At that time, most strains of Mycobacterium tuberculosis were susceptible to first-line tuberculosis drugs, and drug resistance was not a major issue. However, in 2013, tuberculosis remains a major public health concern worldwide, with prevalence of multidrug-resistant (MDR) tuberculosis rising. WHO estimates roughly 630 000 cases of MDR tuberculosis worldwide, with great variation in the frequency of MDR tuberculosis between countries. In the past 8 years, extensively drug-resistant (XDR) tuberculosis has emerged, and has been reported in 84 countries, heralding the possibility of virtually untreatable tuberculosis. Increased population movement, the continuing HIV pandemic, and the rise in MDR tuberculosis pose formidable challenges to the global control of tuberculosis. We provide an overview of the global burden of drug-resistant disease; discuss the social, health service, management, and control issues that fuel and sustain the epidemic; and suggest specific recommendations for important next steps. Visionary political leadership is needed to curb the rise of MDR and XDR tuberculosis worldwide, through sustained funding and the implementation of global and regional action plans.
منابع مشابه
Progress and challenges in childhood tuberculosis.
The plight of children with tuberculosis is widely recognised and is increasingly becoming a priority for national tuberculosis control programmes. In 2012, WHO attempted for the fi rst time to quantify the tuberculosis disease burden in children, estimating there to be 490 000 cases and 65 000 deaths in 2011. Some limitations of this estimation were recognised within the WHO report (table), su...
متن کاملPrevalence ofMultidrug Resistant Mycobacterium tuberculosis by Mycobacteria growth indicator tube in Golestan province, North of Iran
Abstract Background and objectives: Identification and monitoring of multidrug-resistant Mycobacterium tuberculosis strains (MDR) is highlighted by the high risk of their spreading in different areas. Prevalence of these strains was evaluated in Golestan province in northeast of Iran. Material and Methods: Drug susceptibility testing to Isoniazid and rifampin was carried out for 148 clinical sa...
متن کاملEvaluation of Gene Mutations Involved in Drug Resistance in Mycobacterium Tuberculosis Strains Derived from Tuberculosis Patients in Mazandaran, Iran, 2013
Drug resistance (especially multiple drug resistance) in Mycobacterium tuberculosis makes global concerns in treatment and control of tuberculosis. Rapid diagnosis of drug resistant strains of the bacteria has vital importance in the prognosis of the disease. The aim of this study was to identify the mutations responsible for drug resistance in Mycobacterium tuberculosis strains derived from pa...
متن کاملTowards understanding the drivers of policy change: a case study of infection control policies for multi-drug resistant tuberculosis in South Africa
BACKGROUND Explaining policy change is one of the central tasks of contemporary policy analysis. In this article, we examine the changes in infection control policies for multi-drug resistant tuberculosis (MDR-TB) in South Africa from the time the country made the transition to democracy in 1994, until 2015. We focus on MDR-TB infection control and refer to decentralised management as a form of...
متن کاملPulmonary tuberculosis among political asylum seekers screened at Heathrow Airport, London, 1995-9.
BACKGROUND Over 50% of cases of tuberculosis (TB) in the UK occur in people born overseas, and new entrants to the country are screened for TB. A study was undertaken to determine the prevalence and disease characteristics of pulmonary TB in new entrants to the UK seeking political asylum. METHODS A retrospective analysis of the results of screening 53 911 political asylum seekers arriving at...
متن کاملذخیره در منابع من
با ذخیره ی این منبع در منابع من، دسترسی به آن را برای استفاده های بعدی آسان تر کنید
برای دانلود متن کامل این مقاله و بیش از 32 میلیون مقاله دیگر ابتدا ثبت نام کنید
ثبت ناماگر عضو سایت هستید لطفا وارد حساب کاربری خود شوید
ورودعنوان ژورنال:
- The Lancet. Infectious diseases
دوره 13 6 شماره
صفحات -
تاریخ انتشار 2013