Featured Research

from universities, journals, and other organizations

Strategies To Control TB Outdated, Inadequate, Analysis Shows

Date:
August 5, 2008
Source:
American Thoracic Society
Summary:
The standard regimens to treat tuberculosis are inadequate in countries with high rates of multi-drug resistant TB. In countries with high rates of MDR-TB, patients are nearly twice as likely to fail their initial treatment than those in countries with low rates, according to a new analysis of World Health Organization data. This finding suggests strongly that current TB treatment regimens need to updated and revised to address the shifting landscape of public health in the face of MDR-TB.

The standard regimens to treat tuberculosis (TB) are inadequate in countries with high rates of multi-drug resistant (MDR) TB. In countries with high rates of MDR-TB, patients are nearly twice as likely to fail their initial treatment than those in countries with low rates, according to a new analysis of World Health Organization (WHO) data. This finding suggests strongly that current TB treatment regimens need to updated and revised to address the shifting landscape of public health in the face of MDR-TB.

"In countries with low prevalence of initial multi-drug resistance, the standardized treatment regimens for new case appear to be adequate, wrote Dick Menzies, M.D., lead author of the study and director of the respiratory division at McGill University. "However, in countries where the prevalence of initial drug resistance exceeds three percent, we believe it is urgent to strengthen capacity to perform drug sensitivity testing, or to reevaluate these standard treatment regimens, given the unacceptably high rates of failure and relapse."

The study appeared in the first issue for August of the American Thoracic Society's American Journal of Respiratory and Critical Care Medicine.

When the current public health strategies to contain TB were conceived, MDR-TB was much less common. "We hypothesized that, in countries using standardized initial and retreatment regimens, the proportion of patients with poor treatment outcomes would be correlated with prevalence of initial and acquired multi-drug resistance," wrote Dr. Menzies.

To determine if that were the case, Dr. Menzies and co-investigators reviewed the WHO's data from 2003 and 2004 for a total of 155 countries, 121 of which reported at least 250 cases annually. They assessed dropout, failure, relapse and death rates with initial treatment, as well as dropout, failure and death rates for retreatment. All rates were analyzed with respect to the prevalence of MDR-TB in each country.

They were right: rates of failed treatment were dramatically higher with increasing prevalence of MDR-TB (p<0.0001). In fact, after accounting for age, HIV prevalence, per capita income and treatment regimen, for every one-percent increase in MDR TB prevalence, they saw a 0.30 percent rise in treatment failure among new cases, a 1.1 percent increase in failure rate among RE-treatment cases, and a one percent increase in relapse. "This is striking evidence that MDR-TB is directly linked to the increased failure rates of our current treatment regimens," said Dr. Menzies.

Overall, the proportion of patients requiring retreatment nearly doubled between countries with low and high prevalence of MDR-TB, from 11.9 percent in countries with initial MDR prevalence of less than one percent, to 21.4 percent in countries with MDR prevalence of more than three percent. "In the short term, the higher the failure and relapse rates mean greater morbidity and mortality for patients, with greater social and economic harm for their families and communities. In the long term, these standardized regimens may be contributing to amplification of multi-drug resistance in these countries," wrote Dr. Menzies.

The concern is that with current treatment regimens, many patients fail treatment or relapse later, and by continuing to use those regimens, researchers and public health officials may be unwittingly increasing the problem of drug resistance and multiplying the problem for other future patients. "Unless those with the responsibility to boost control and research efforts increase their commitments and their financial investments by several fold, we may never see elimination of this major scourge in the decades to come," wrote Marcos Espinal, M.D., and Mario C. Raviglione, M.D., both of the WHO, in an accompanying editorial in the same issue of the journal.


Story Source:

The above story is based on materials provided by American Thoracic Society. Note: Materials may be edited for content and length.


Cite This Page:

American Thoracic Society. "Strategies To Control TB Outdated, Inadequate, Analysis Shows." ScienceDaily. ScienceDaily, 5 August 2008. <www.sciencedaily.com/releases/2008/08/080801074100.htm>.
American Thoracic Society. (2008, August 5). Strategies To Control TB Outdated, Inadequate, Analysis Shows. ScienceDaily. Retrieved September 16, 2014 from www.sciencedaily.com/releases/2008/08/080801074100.htm
American Thoracic Society. "Strategies To Control TB Outdated, Inadequate, Analysis Shows." ScienceDaily. www.sciencedaily.com/releases/2008/08/080801074100.htm (accessed September 16, 2014).

Share This



More Health & Medicine News

Tuesday, September 16, 2014

Featured Research

from universities, journals, and other organizations


Featured Videos

from AP, Reuters, AFP, and other news services

EU Ministers and Experts Meet to Discuss Ebola Reponse

EU Ministers and Experts Meet to Discuss Ebola Reponse

AFP (Sep. 15, 2014) The European Commission met on Monday to coordinate aid that the EU can offer to African countries affected by the Ebola outbreak. Duration: 00:58 Video provided by AFP
Powered by NewsLook.com
Despite The Risks, Antibiotics Still Overprescribed For Kids

Despite The Risks, Antibiotics Still Overprescribed For Kids

Newsy (Sep. 15, 2014) A new study finds children are prescribed antibiotics twice as often as is necessary. Video provided by Newsy
Powered by NewsLook.com
FDA Eyes Skin Shocks Used at Mass. School

FDA Eyes Skin Shocks Used at Mass. School

AP (Sep. 15, 2014) The FDA is considering whether to ban devices used by the Judge Rotenberg Educational Center in Canton, Massachusetts, the only place in the country known to use electrical skin shocks as aversive conditioning for aggressive patients. (Sept. 15) Video provided by AP
Powered by NewsLook.com
Respiratory Virus Spreads To Northeast, Now In 21 States

Respiratory Virus Spreads To Northeast, Now In 21 States

Newsy (Sep. 14, 2014) The respiratory virus Enterovirus D68, which targets children, has spread from the Midwest to 21 states. Video provided by Newsy
Powered by NewsLook.com

Search ScienceDaily

Number of stories in archives: 140,361

Find with keyword(s):
Enter a keyword or phrase to search ScienceDaily for related topics and research stories.

Save/Print:
Share:

Breaking News:
from the past week

In Other News

... from NewsDaily.com

Science News

Health News

Environment News

Technology News



Save/Print:
Share:

Free Subscriptions


Get the latest science news with ScienceDaily's free email newsletters, updated daily and weekly. Or view hourly updated newsfeeds in your RSS reader:

Get Social & Mobile


Keep up to date with the latest news from ScienceDaily via social networks and mobile apps:

Have Feedback?


Tell us what you think of ScienceDaily -- we welcome both positive and negative comments. Have any problems using the site? Questions?
Mobile: iPhone Android Web
Follow: Facebook Twitter Google+
Subscribe: RSS Feeds Email Newsletters
Latest Headlines Health & Medicine Mind & Brain Space & Time Matter & Energy Computers & Math Plants & Animals Earth & Climate Fossils & Ruins