Prevalence of Drug Resistant Tuberculosis (TB) and Its Challenges to Public Health in the World

 Tuberculosis has possibly killed more human beings than any other disease throughout history. With almost 9 million new cases each year, TB remains one of the most feared diseases on the planet. Despite the recent advances of global control efforts, tuberculosis remains a major public health problem in most developing countries. Current global estimates indicate that about a third of the world's population is infected with Mycobacterium tuberculosis and almost 1.7 million TB deaths are occurred in 2006.

SOAR

Into the 21st century it is still one of the leading cause of deaths among all infectious diseases, killing at least 2 million people every year. The situation became even worse by the emergence of antibiotic-resistant strains of Mycobacterium tuberculosis. Anyone of any race, age or nationality can contract TB, but certain factors increase risk of the disease.

Tuberculosis has been described a disease of poverty, but other factors are likely to be important as well. There are two well-known types of drug resistant TB:

1. Multidrug-resistant TB and

2. Extensively drug-resistant TB.

Any patient with drug resistant Tuberculosis either has not been treated properly, did not take the medication as prescribed, or was infected by someone who had not been treated properly or did not take their medication as prescribed. With increased international travel, TB and inevitably Drug Resistant strains of Mycobacterium Tuberculosis, is readily circulating throughout the world.

Why drug resistant tuberculosis in developing countries is much more prevalent than in developed countries?

Factors affecting the success of tuberculosis:

1. Socio-economic

Approximately 4 billion people, or 80% of the total global population, live in developing areas of the world. Mainly have entered the 21st century without having fully benefited from the remarkable advances in health care achieved during the previous one; as many as 1 billion, with no having benefited at all.

2. Role of Health care providers in drug resistant

The use of inadequate regimens and the lack, or inappropriate application, of directly observed treatment can lead to the development of drug resistance and potentially to a raise in drug resistance levels in the community. The implementation of a good quality DOTS program will prevent the emergence and spread of MDR and XDR-TB in the community.

3. Inadequate supply and quality of TB Drugs

Ensuring an uninterrupted supply of quality drugs through the GDF (The Global TB Drug Facility) will free human and financial resources to address management, service delivery, training, supervision, and other services essential for scaling up DOTS.

4. Inadequate drug intake by patients

Inadequate treatment intake is often associated with emergence and expansion of multidrug resistant strains. It is easier to prevent MDR-TB from arising through poor treatment than to bring an established epidemic under control. Some patients may experience problems, drug related side effects might be minor or major and a patient who experience side effects may not be encouraged to continue the treatment.

The continued spread of MDR or XDR TB has the potential to paralyze TB care programs and public health infrastructure in resource limited countries.