Multidrug-resistant tuberculosis, or MDR TB, is epidemic worldwide, and the World Health Organization (WHO) is reporting that improved data collection techniques now indicate that the number of reported cases of MDR-TB has skyrocketed. More than 500,000 cases of the disease have gone uncounted because of an error in the reporting and collecting of pertinent data. This newly found information casts doubt on the management of this epidemic, despite intensive efforts at eradicating the deadly disease.
In a detailed report published Oct. 22, the WHO’s “Global Tuberculosis Report 2014” found that an estimated 9 million people worldwide contracted the disease in 2013, with 1.5 million people dying from the debilitating lung infection. Tuberculosis is the number two killer of people worldwide from a “single infectious agent,” trailing only HIV/AIDS. Of the 9 million reported cases, 1.1 million had HIV, and 360,000 people with the HIV virus died from tuberculosis in 2013. Another alarming statistic shows that 510,000 women died from TB in 2012, and 180,000 of these women had tested positive for HIV. This data indicates that of the 360,000 HIV-positive people who died from TB last year, fully one half were women.
The incidence of death attributed to TB worldwide has continued to decline by upwards of 45 percent since its high in 1990. New infections of the lung disease have decreased by 1.5 percent each year on average. According to Dr. Mario Raviglione, director of the Global TB program, WHO, the newly adopted rules for monitoring and reporting multidrug-resistant tuberculosis will bring the WHO and the tuberculosis community “closer to understanding the true burden of tuberculosis,” adding that, “routine surveillance efforts” by all of the involved parties will bring an increase in better, more relevant data so that the TB numbers do not appear to skyrocket as sharply as they have with today’s report.
The U.S. Food and Drug Administration (FDA) approved a drug in 2012 for the treatment of multidrug-resistant tuberculosis when normal treatment options are not available to some people, or when the strain of TB that person has does not respond to standardized treatment options. That drug is called bedaquiline, and is marketed under the brand name Sirturo. It is generally used in combination with the drugs isonazid and rifampin, the two most commonly used drugs to treat this disease.
Tuberculosis is an infectious disease caused by the mycobacteria named mycobacterium tuberculosis. TB is an acronym for the term tubercle bacillus, and is used as an abbreviation. It is an upper respiratory ailment, and is spread in most cases when an infected patient coughs, sneezes, vomits or spews fluid from the respiratory tract. It is extremely contagious and often fatal. Tuberculosis has a 22 percent mortality rate. Multidrug-resistant tuberculosis has an even higher mortality rate.
Multidrug-resistant tuberculosis outbreaks are generally centered in Eastern Europe and Central Asia, and it has been estimated that 480,000 new cases were discovered in those areas in 2013. Severe epidemics of the disease have been reported, and the cure rate for MDR TB is extremely low in the epidemic regions of Eastern Europe and Central Asia. Progress has been made in the battle against multidrug-resistant tuberculosis and “must be intensified,” said Dr. Karin Weyer, WHO Coordinator for Laboratories, Diagnostics and Drug Resistance.
While WHO is reporting an overall increase in the reported cases of multidrug-resistant tuberculosis, the recent new criteria for reporting have shown that the numbers have skyrocketed to some degree. Major funding is needed to eliminate this global threat, and current funding levels are insufficient to properly battle this deadly disease.
By Jim Donahue