Europe threatened by drug-resistant TB strains

The prevalence of strains of resistant tuberculosis in Eastern Europe is a major concern to public health in the European Union.

According to a World Health Organisation (WHO) report published today, patients with tuberculosis in parts of Eastern Europe and Central Asia are 10 times more likely to have multi-drug resistant TB (MDR-TB) than in the rest of the world.

The research, covering 67,657 TB patients in 77 countries and regions, has revealed geographical concentrations of TB drug resistance. Six out of the top ten global hotspots are: Estonia, Kazakhstan, Latvia, Lithuania, parts of the Russian Federation and Uzbekistan, with drug resistance in new patients as high as 14%.

"TB drug resistance is an urgent public health issue for countries from the former Soviet Union," said Dr Mario Raviglione, Director of WHO's Stop TB Department.

"It is in the interest of every country to support rapid scale-up of TB control if we are to overcome MDR-TB. Passport control will not halt drug resistance; investment in global TB prevention will."

Infectious disease experts estimate there are 300,000 new cases per year of MDR-TB worldwide. Worryingly there is also evidence that drug resistant strains are becoming more resistant. Almost four out of five MDR-TB cases are now "super strains", resistant to at least three of the four main drugs used to cure TB.

Though curing 'normal' TB is cheap and effective, a six-month course of medicines costs $10, treating MDR-TB is a hundred times more expensive as the organism is resistant to the two most common drugs used.

Some successes have been achieved since the last study four years ago - most notably in Cuba, Hong Kong and the United States. Rates in those countries have decreased due to strong anti-TB strategies.

Known as DOTS the strategy is designed to ensure patients take their medicines properly and has proven effective in preventing drug resistance.

The report also notes TB control strategies used in Eastern Europe and the Russian Federation have recently begun to improve with the introduction of DOTS, and the 'DOTS Plus' scheme to diagnose and effectively treat drug resistant TB.

(SP)