Published: Fri, March 24, 2017
Medicine | By Megan Pierce

New Tuberculosis Drugs May Become Ineffective

New Tuberculosis Drugs May Become Ineffective

Plus, many extrapulmonary infections are now resistant to one or more first-line TB drugs, which may contribute to its higher mortality rates. As a small country, we can not afford to have large drug-resistant TB outbreaks occurring. Primary drug resistant TB may also be transmitted from person to person.

Globally, in 2015, there were an estimated 480,000 cases of the multidrug-resistant type, with approximately half of these cases being in India, China, and Russian Federation. Tuberculosis is still a real threat for many Canadians, particularly the homeless and Indigenous people who have not experienced improvements in nutrition and housing, as well as people from countries where TB remains widespread.

Although a small number of repurposed and new drugs have recently become available to treat drug-resistant TB - including bedaquiline, delamanid, and linezolid -, without accurate diagnostics, clear treatment guidelines and improved control efforts, the effectiveness of the drugs could be rapidly lost, the researchers stated. TB patients require higher levels of energy and metabolic immunity to cope with the infection, and understandably this need is higher in children during to their growth phase.

And yet, a growing proportion of new TB cases occur in people without HIV. HIV-induced TB can be effectively addressed through workplace interventions among formal/informal sectors.

But because resistant strains were thought to be less virulent and transmissible than susceptible strains, more emphasis has been placed on poor treatment compliance as the main source of drug-resistant TB.

Most drug resistant TB cases emerge because of ineffective and mismanaged treatment, and low adherence. Unfortunately, complacency around TB is also the reason few innovative treatments are being developed.

A majority of TB patients around the world suffer from strains of the contagious pathogen Mycobacterium tuberculosis in their lungs.Mycobacterium tuberculosis (or M. tuberculosis, for short) usually causes painful and long-lasting coughs, weakness, weight loss and fevers.

Head of Groote Schuur Hospital's Pulmonology Department Professor Keertan Dheda says 20,000 multidrug-resistant TB cases were registered across the country in 2014.

According to the World Health Organization, 480,000 people were affected with MDR-TB in 2015 worldwide. There is mounting evidence that drug-resistant TB can spread readily from person to person; rather than an individual developing drug resistance over time, a previously uninfected individual could have extensively drug-resistant TB from the beginning.

In Thailand, as part of the national health system's focus on universal health coverage with financial protection, the national TB Strategic Plan seeks to eliminate catastrophic costs and access barriers for key vulnerable groups including migrants, prisoners, people living with HIV, children, and older people. That study found that out of 404 patients who had been diagnosed as having XDR-TB in South Africa's KwaZulu-Natal province, almost 70% had no history of antibiotic treatment.

Unfortunately, the success of those drugs has led to a complacency that is preventing us from taking the necessary measures against this disease.

His discovery paved the way to diagnosing and curing TB, an infectious disease that afflicts one-third of the world's population. "But it's also possible that we could start to use the tools we have...to really reverse the epidemic". Some forms of latent TB treatment may be considered via DOT (for example, a weekly regime for three months). The difference between these two outcomes lies less with the pathogen and more with us as a global tuberculosis control community and whether we have the political will to prioritise a specific response to the disease. The issue, though, is whether the global will exists to make drug-resistant TB a priority and provide the financial resources needed to tackle the problem.

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