Tag Archives: tuberculosis

China: Nearly 120,000 new cases of tuberculosis every year

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Heav­ily bur­dened by ris­ing multidrug-resistant tuber­cu­lo­sis (MDR-TB), China now has nearly 120,000 new cases on the main­land each year, accord­ing to pub­lic health experts. That accounts for 25% of the world’s total per year, accord­ing to sta­tis­tics from the Chi­nese Cen­ter for Dis­ease Con­trol and Pre­ven­tion. MDR-TB is defined as TB, which is resis­tant to at least iso­ni­azid and rifampicin, the most pow­er­ful first-line anti-TB drugs.

“MDR-TB needs more com­pli­cated diag­no­sis meth­ods, longer and much more expen­sive treat­ment com­pared with com­mon TB, which causes huge eco­nomic and human resource loss,” said Chen Mingt­ing, deputy direc­tor of the National Cen­ter for Tuber­cu­lo­sis of China CDC. With no effec­tive inter­ven­tion, the num­ber of MDR-TB patients in China is expected to reach 710,000 on the main­land by 2020, which would incur an eco­nomic loss of more than 99 bil­lion yuan (about USD 16.1 bil­lion) mostly in med­ical treat­ment, he said, cit­ing pre­vi­ous stud­ies by CDC. “That might upset social sta­bil­ity and harm eco­nomic devel­op­ment of the nation,” he said.

Cur­rently, the Chi­nese gov­ern­ment pro­vides free treat­ment for com­mon TB but not for MDR-TB, which costs much more for treat­ment. To help enrich drug choices for MDR-TB, the State Food and Drug Admin­is­tra­tion has approved the new med­i­cine Sir­turo, by Xi’an Janssen Phar­ma­ceu­ti­cal Ltd.

World­wide, about 1/3 of the total pop­u­la­tion is infected with the bac­terium that causes TB, Mycobac­terium tuber­cu­lo­sis, and nearly 4% of those newly infected are ini­tially resis­tant to mul­ti­ple drugs (pri­mary drug resis­tance), accord­ing to the World Health Orga­ni­za­tion. That means that resis­tant forms of the dis­ease are being trans­mit­ted directly from peo­ple to peo­ple, med­ical experts said.

The full arti­cle may be accessed at http://www.promedmail.org/direct.php?id=20130421.1661848

(ProMED 4/21/2013)

Global: WHO says TB numbers in Southeast Asia and Western Pacific improve

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Apro­pos to World TB Day on 24 March 2013, the World Health Orga­ni­za­tion (WHO) on 21 March 2013 issued reports on strides in the con­tain­ment of tuber­cu­lo­sis (TB) in South­east Asia and the West­ern Pacific Region but said work is still needed. Since 1990, the TB death rate in South­east Asia has declined by more than 40% and dis­ease preva­lence about 25%, the agency said, in large part because of expanded access to TB care. In addi­tion to improved access, advances in diag­nos­tics have con­tributed to the improved num­bers. The WHO stressed, how­ever that num­bers of TB cases remain high, with 3.5 mil­lion new cases and half a mil­lion TB deaths in 2011. In addi­tion, con­cern is focused on multidrug-resistant infec­tions, which con­sti­tute nearly a third of cases. WHO West­ern Pacific Region (WPRO) said a lack of access to diag­no­sis and treat­ment for chil­dren and the elderly accounts for the still-high num­bers of TB patients there. High-burden coun­tries in the region pro­vide free diag­no­sis and treat­ment, but aware­ness of the pro­grams and an inabil­ity to access care, espe­cially in the elderly, are still lack­ing. Elim­i­na­tion of TB needs coor­di­nated efforts from the health­care, envi­ron­men­tal, infec­tion con­trol, water, and san­i­ta­tion sec­tors, the WHO added. On 18 March 2013, the agency called for $1.6 bil­lion in increased TB funding.

(CIDRAP 3/21/2013)

 

Australia: Drug-resistant tuberculosis knocks at door

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Australia’s first death from XDR-TB — exten­sively drug-resistant tuber­cu­lo­sis, which is nearly incur­able — has alarmed health offi­cials and added new heat to a debate over how to treat immi­grants with dan­ger­ous dis­eases. That debate echoes one on the United States’ south­ern border.

A long string of small Aus­tralian islands — bits of what was once a land bridge — min­gle with islands belong­ing to Papua New Guinea, one of the world’s poor­est nations. One of those islands, Daru, has a major TB out­break in its shan­ty­towns. Aus­tralia used to have two TB clin­ics on its islands, but closed them in 2011 and sent many patients back to Daru, instead offer­ing for­eign aid to help them be treated at home.

But the health sys­tem in Papua New Guinea is over­whelmed, and there are accu­sa­tions that the for­eign aid has been stolen. The World Health Orga­ni­za­tion found seri­ous drug short­ages, and XDR patients were showed min­gling with oth­ers in Daru Hos­pi­tal tuber­cu­lo­sis wards, rais­ing the risk of spread­ing resis­tant strains.

Cathe­rina Abra­ham, a 20-year-old Daru woman, went to Aus­tralia on a tourist visa in 2012 but ended up as a “med­ical refugee,” spend­ing months in iso­la­tion in a Queens­land hos­pi­tal, pos­ing for pic­tures and giv­ing inter­views before she died on 8 March 2013. Aus­tralia, which oth­er­wise has lit­tle tuber­cu­lo­sis within its bor­ders, is still debat­ing how to respond. Treat­ment for drug-resistant TB — when it works — can cost hun­dreds of thou­sands of dol­lars. Experts noted that the same prob­lem exists on the bor­ders between the United States and Mex­ico and between Fin­land and Russia.

(New York Times 3/25/2013)