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Publication Details
AFRICAN RESEARCH NEXUS
SHINING A SPOTLIGHT ON AFRICAN RESEARCH
medicine
Epidemiology of antituberculosis drug resistance 2002-07: an updated analysis of the Global Project on Anti-Tuberculosis Drug Resistance Surveillance
The Lancet, Volume 373, No. 9678, Year 2009
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Description
Background: The Global Project on Anti-Tuberculosis Drug Resistance has been gathering data since 1994. This study provides the latest data on the extent of drug resistance worldwide. Methods: Data for drug susceptibility were gathered from 90 726 patients in 83 countries and territories between 2002 and 2007. Standardised collection of results enabled comparison both between and within countries. Where possible, data for HIV status and resistance to second-line drugs were also obtained. Laboratory data were quality assured by the Supranational Tuberculosis Reference Laboratory Network. Findings: The median prevalence of resistance to any drug in new cases of tuberculosis was 11·1% (IQR 7·0-22·3). The prevalence of multidrug resistance in new tuberculosis cases ranged from 0% in eight countries to 7% in two provinces in China, 11·1% in Northern Mariana Islands (although reporting only two cases), and between 6·8% and 22·3% in nine countries of the former Soviet Union, including 19·4% in Moldova and 22·3% in Baku, Azerbaijan (median for countries surveyed 1·6%, IQR 0·6-3·9). Trend analysis showed that between 1994 and 2007, the prevalence of multidrug-resistant (MDR) tuberculosis in new cases increased substantially in South Korea and in Tomsk Oblast and Orel Oblast, Russia, but was stable in Estonia and Latvia. The prevalence of MDR tuberculosis in all tuberculosis cases decreased in Hong Kong and the USA. 37 countries and territories reported representative data on extensively drug-resistant (XDR) tuberculosis. Five countries, all from the former Soviet Union, reported 25 cases or more of XDR tuberculosis each, with prevalence among MDR-tuberculosis cases ranging between 6·6% and 23·7%. Interpretation: MDR tuberculosis remains a threat to tuberculosis control in provinces in China and countries of the former Soviet Union. Data on drug resistance are unavailable in many countries, especially in Africa, emphasising the need to develop easier methods for surveillance of resistance in tuberculosis. Funding: Global Project: United States Agency for International Development and Eli Lilly and Company. Drug resistance surveys: national tuberculosis programmes, the Government of the Netherlands, the Global Fund to Fight AIDS, Tuberculosis and Malaria, Japan International Cooperation Agency, and Kreditanstalt für Wiederaufbau. © 2009 Elsevier Ltd. All rights reserved.
Authors & Co-Authors
Wright, Abigail
Switzerland, Geneva
Organisation Mondiale de la Santé
Zignol, Matteo
Switzerland, Geneva
Organisation Mondiale de la Santé
van Deun, Armand
France, Paris
International Union Against Tuberculosis and Lung Disease
Belgium, Antwerpen
Prins Leopold Instituut Voor Tropische Geneeskunde
Falzon, Dennis
France, Saint-maurice
Institut de Veille Sanitaire
Gerdes, Sabine Ruesch
Germany, Borstel
National Reference Centre for Mycobacteria
Feldman, Knut
Germany, Gauting
Institute for Laboratory Medicine
Hoffner, Sven Erik
Sweden, Solna
Public Health Agency of Sweden
Drobniewski, Francis A.
United Kingdom, London
Public Health England
Barrera, Lucia
Argentina, Buenos Aires
National Institute of Infectious Diseases
van Soolingen, Dick
Netherlands, Bilthoven
Rijksinstituut Voor Volksgezondheid en Milieu
Boulabhal, Fadila
Algeria, Algiers
Institut Pasteur - Alger
Paramasivan, CN N.
India, New Delhi
Indian Council of Medical Research
Kam, Kaiman
China, Hong Kong
Hong Kong Government
Mitarai, Satoshi
Japan, Kiyose
The Research Institute of Tuberculosis, Japan Anti-tuberculosis Association
Nunn, Paul P.
Switzerland, Geneva
Organisation Mondiale de la Santé
Raviglione, Mario C.
Switzerland, Geneva
Organisation Mondiale de la Santé
Statistics
Citations: 407
Authors: 16
Affiliations: 14
Identifiers
Doi:
10.1016/S0140-6736(09)60331-7
ISSN:
01406736
Research Areas
Infectious Diseases
Study Design
Cross Sectional Study