Report: Drug-resistant TB a big threat
By Xin Dingding (China Daily)
Updated: 2004-03-16 23:52

Tuberculosis patients in parts of Eastern Europe and Central Asia are 10 times more likely to have multidrug-resistant TB than in the rest of the world, according to a World Health Organization (WHO) report released Tuesday.

And China was identified in the report as one of the key areas for the deadly infectious disease.

The report, which surveys 77 countries and regions making up one fifth of the world's population, includes four settings in China.

Two provinces out of the four surveyed were found to have a "very high" percentage of multidrug-resistant TB patients, said the report's leading author Dr Mohamed Aziz.

The report indicated around one out of every 10 new patients tested positive for multidrug-resistant TB in Northeast China's Liaoning Province, and eight in every 100 new patients in Central China's Henan Province are resistant to more than two important drugs.

But the situation is better in Central China's Hubei Province and Hong Kong, said Aziz in a phone interview with China Daily.

Only 0.8 per cent of TB patients are drug resistant in Hong Kong, a percentage lower than average, and 2.1 per cent are drug resistant in Hubei, which shows the situation is "within control", said Aziz.

Multidrug-resistant TB has been considered more dangerous and fatal in most cases, because it is harder to cure. Patients infected with it have to take second-line drugs which are much more expensive with more side effects. Longer treatments are also required.

Once TB patients develop a drug resistant strain of the illness due to inconsistent treatment, wrong treatment regimens or unreliable drug supply, they can spread it to others, said Dr Aziz.

Statistics with WHO show tuberculosis kills approximately 2 million people each year. The breakdown in health services, the spread of HIV/AIDS and the emergence of multidrug-resistant TB are contributing to the worsening impact of this disease.

It is estimated that between 2002 and 2020, approximately 1 billion people will be infected, over 150 million people will get sick, and 36 million will die of TB -- if control is not further strengthened.

"It is in the interest of every country to support rapid scale-up of TB control if we are to overcome multidrug-resistant TB," he said.

"Passport control will not halt drug resistance; investment in global TB prevention will," said Dr Mario Raviglione, director of WHO's Stop TB Department.

"China is doing well in expansion of the drug resistance tuberculosis surveillance project," said Aziz.

Now China's health administration and WHO are planning to carry out a national TB project together.

The WHO expert said surveys will be carried out in more provinces, and multidrug-resistant TB patients found by new surveys will be offered treatment with second-line drugs.

Thanks to WHO's initiatives, the cost of supplying these medicines has fallen dramatically, as pharmaceutical companies have agreed to fully support the fight to eradicate drug resistant TB.

But who pays for the treatment has not been decided yet, he added.

At present, TB patients in China are treated with DOTS, commonly known as the "most effective strategy to prevent the emergence of drug resistance," according to Wan Liya, an official with the Ministry of Health.

Wan said 80 per cent of TB cases were found in rural China before, but now the infectious disease is spreading to cities with the flow of farmer labourers.

"The number of TB patients in Beijing has been growing in recent years," she said.

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