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Publication Details
AFRICAN RESEARCH NEXUS
SHINING A SPOTLIGHT ON AFRICAN RESEARCH
medicine
Global trends in resistance to antituberculosis drugs
New England Journal of Medicine, Volume 344, No. 17, Year 2001
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Description
Background: Data on global trends in resistance to antituberculosis drugs are lacking. Methods: We expanded the survey conducted by the World Health Organization and the International Union against Tuberculosis and Lung Disease to assess trends in resistance to antituberculosis drugs in countries on six continents. We obtained data using standard protocols from ongoing surveillance or from surveys of representative samples of all patients with tuberculosis. The standard sampling techniques distinguished between new and previously treated patients, and laboratory performance was checked by means of an international program of quality assurance. Results: Between 1996 and 1999, patients in 58 geographic sites were surveyed; 28 sites provided data for at least two years. For patients with newly diagnosed tuberculosis, the frequency of resistance to at least one antituberculosis drug ranged from 1.7 percent in Uruguay to 36.9 percent in Estonia (median, 10.7 percent). The prevalence increased in Estonia, from 28.2 percent in 1994 to 36.9 percent in 1998 (P=0.01), and in Denmark, from 9.9 percent in 1995 to 13.1 percent in 1998 (P=0.04). The median prevalence of multidrug resistance among new cases of tuberculosis was only 1.0 percent, but the prevalence was much higher in Estonia (14.1 percent), Henan Province in China (10.8 percent), Latvia (9.0 percent), the Russian oblasts of Ivanovo (9.0 percent) and Tomsk (6.5 percent), Iran (5.0 percent), and Zhejiang Province in China (4.5 percent). There were significant decreases in multidrug resistance in France and the United States. In Estonia, the prevalence in all cases increased from 11.7 percent in 1994 to 18.1 percent in 1998 (P<0.001). Conclusions: Multidrug-resistant tuberculosis continues to be a serious problem, particularly among some countries of eastern Europe. Our survey also identified areas with a high prevalence of multidrug-resistant tuberculosis in such countries as China and Iran. Copyright © 2001 Massachusetts Medical Society.
Authors & Co-Authors
Espinal, Marcos Antonio
Switzerland, Geneva
Organisation Mondiale de la Santé
Laszlo, Adalbert
France, Paris
International Union Against Tuberculosis and Lung Disease
Canada, Ottawa
Laboratory Centre for Disease Control
Simonsen, Lone
Switzerland, Geneva
Organisation Mondiale de la Santé
Boulahbal, Fadila
Algeria, Algiers
Institut Pasteur - Alger
Kim, Sang-jae
South Korea, Seoul
The Korean National Tuberculosis Association
Reniero, Ana
Argentina, Buenos Aires
Instituto Panamericano de Protección de Alimentos y Zoonosis
Hoffner, Sven Erik
Sweden, Solna
Public Health Agency of Sweden
Rieder, Hans L.
France, Paris
International Union Against Tuberculosis and Lung Disease
Binkin, Nancy J.
United States, Atlanta
Centers for Disease Control and Prevention
Dye, Christopher
Switzerland, Geneva
Organisation Mondiale de la Santé
Williams, Rosamund
Switzerland, Geneva
Organisation Mondiale de la Santé
Raviglione, Mario C.
Switzerland, Geneva
Organisation Mondiale de la Santé
Statistics
Citations: 709
Authors: 12
Affiliations: 8
Identifiers
Doi:
10.1056/NEJM200104263441706
ISSN:
00284793
Study Design
Cross Sectional Study
Study Approach
Quantitative