Multidrug-resistant tuberculosis around the world: what progress has been made?

Dennis Falzon, Fuad Mirzayev, Fraser Wares, Inés Garcia Baena, Matteo Zignol, Nguyen Linh, Karin Weyer, Ernesto Jaramillo, Katherine Floyd, Mario Raviglione, Dennis Falzon, Fuad Mirzayev, Fraser Wares, Inés Garcia Baena, Matteo Zignol, Nguyen Linh, Karin Weyer, Ernesto Jaramillo, Katherine Floyd, Mario Raviglione

Abstract

Multidrug-resistant tuberculosis (MDR-TB) (resistance to at least isoniazid and rifampicin) will influence the future of global TB control. 88% of estimated MDR-TB cases occur in middle- or high-income countries, and 60% occur in Brazil, China, India, the Russian Federation and South Africa. The World Health Organization collects country data annually to monitor the response to MDR-TB. Notification, treatment enrolment and outcome data were summarised for 30 countries, accounting for >90% of the estimated MDR-TB cases among notified TB cases worldwide. In 2012, a median of 14% (interquartile range 6-50%) of estimated MDR-TB cases were notified in the 30 countries studied. In 15 of the 30 countries, the number of patients treated for MDR-TB in 2012 (71 681) was >50% higher than in 2011. Median treatment success was 53% (interquartile range 40-70%) in the 25 countries reporting data for 30 021 MDR-TB cases who started treatment in 2010. Although progress has been noted in the expansion of MDR-TB care, urgent efforts are required in order to provide wider access to diagnosis and treatment in most countries with the highest burden of MDR-TB.

Conflict of interest statement

Conflict of interest: None declared.

The content of this work is ©World Health Organization. Design and branding are ©ERS 2015.

Figures

FIGURE 1
FIGURE 1
a) New and b) retreatment tuberculosis cases with drug-susceptibility test results for isoniazid and rifampicin, 2012, by country. Inadequate linkage between clinical and laboratory registers may result in an overestimation of drug-susceptibility testing coverage (e.g. >100% in Kazakhstan).
FIGURE 2
FIGURE 2
Multidrug-resistant tuberculosis (MDR-TB) cases and additional rifampicin-resistant TB cases detected, compared with TB cases enrolled on MDR-TB treatment, trend in target countries, 2009−2012.
FIGURE 3
FIGURE 3
Treatment outcomes for patients diagnosed with multidrug-resistant tuberculosis by target country, 2007−2010 cohorts. The total number of cases in each annual cohort is shown on the bars.
FIGURE 4
FIGURE 4
Multidrug-resistant tuberculosis (MDR-TB) notifications and percentage of funding received for second-line drugs from external sources, by income group, 2012. a) high-income group; b) upper middle-income group; c) lower middle-income group; d) low-income group. Only countries that reported data for both domestic and external funding are shown.

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Source: PubMed

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