Anti-tuberculosis Drug Resistance in the World: Report no. 2: Prevalence and Trends

Marcos A. Espinal, Lone Simonsen, Adalbert Laszlo, Fadila Boulahbal, Sang Jae Kim, Ana Reniero, Sven Hoffner, Hans L. Rieder, Nancy Binkin, Christopher Dye, Rosamund Williams, Mario C. Raviglione

Research output: Book/ReportReportCommunication

Abstract

In 1997, the World Health Organization (WHO), the International Union Against
Tuberculosis and Lung Disease (IUATLD) and several partners worldwide released the first report of the Global Project on Anti-tuberculosis Drug Resistance Surveillance (DRS) (herein referred to as the “Global Project”). This report presented data from 35 geographical settings* (surveyed between 1994 and 1996) using standard epidemiological and laboratory guidelines. These data covered 16% of the World’s notified tuberculosis (TB) cases.
The first report of the Global Project showed that drug-resistant Mycobacterium tuberculosis (M. tuberculosis) was present in all geographical settings surveyed and that multidrugresistant tuberculosis (MDR-TB), defined as resistance to at least isoniazid (INH) and rifampicin (RMP), was a problem in certain settings. A prevalence of greater than 3% of MDR-TB among new cases was found in six geographical settings (Argentina, Dominican Republic, Estonia, Latvia, Côte d’Ivoire, and Ivanovo Oblast in the Russian Federation.
These findings prompted WHO to establish the DOTS-PLUS research initiative aiming to assess the feasibility and cost-effectiveness of programmatic interventions to manage patients with MDR-TB in middle- and low-income countries. The data from this initiative will be used to guide the design of comprehensive policy guidelines for the management of
MDR-TB in settings with limited resources.
Trends in drug resistance could not be evaluated in the first phase of the Global
Project, as only one data point from the 35 geographical settings surveyed was available. Thus, the need to expand surveillance to other geographical settings and to continue the monitoring of settings already covered for the assessment of trends of drug resistance was considered high priority.
This second report of the Global Project describes the progress of this international collaborative effort. This report contains data from 72 geographical settings involved in the Global Project between 1994 and 1999. These data are distributed as follows:
i) information collected in the period 1996–1999 on the prevalence of drug resistance from 58 geographical settings;
ii) trends on drug resistance from 28 geographical settings, 20 of which were originally included in the first report;
iii) data from 17 geographical settings on the levels of drug resistance according to place of birth;
iv) individual patient data from 11 geographical settings to assess determinants of drug resistance;
vi) ecological data from all 72 geographical settings that have participated in the Global Project since 1994.
Original languageEnglish
PublisherWorld Health Organization
Number of pages17
Publication statusPublished - 2000
Externally publishedYes
SeriesWorld Health Organization: WHO/IUATLD Global Project on Anti-tuberculosis Drug Resistance Surveillance. WHO/CDS/B/2000.278

Keywords

  • Tuberculosis
  • Drug resistance
  • Global trends
  • surveillance
  • WHO

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