Drug resistance, particularly through multidrug-resistant tuberculosis (TB) and extensively drug-resistant TB strains, poses a real threat to TB control worldwide. Recent reports from the WHO and the International Union Against Tuberculosis and Lung Disease demonstrate that the emerging epidemic of drug-resistant TB is a global problem, although emphasis has been placed on several ‘hot spots’ because of lack of good global data.
The present article is aimed at reviewing the available information on drug-resistant TB with special focus on the features of the epidemic in Europe, Russia, Latin America, Asia and specifically China, and to discuss the global perspectives related to drug-resistant TB control and care.
Drug-resistant TB originates from different human errors, including misuse of anti-TB drugs and other reasons related to prescribers, patients and drug producers. Although there is an urgent need for new drugs, a sound public health approach is necessary for their introduction in clinical treatment settings to prevent/avoid creating additional resistance, as has already been observed for first and second-line anti-TB drugs in many settings.
aWHO Collaborating Centre for TB and Lung Diseases, Fondazione S. Maugeri, Care and Research Institute, Tradate, Italy
bDivision of Clinical Infectious Diseases, Medical Clinic, Research Centre Borstel, Borstel, Germany
cHIV/TB Global Program, PATH, Seattle, Washington, USA
dHygiene and Preventive Medicine Institute, University of Sassari, Sassari, Italy
Correspondence to Giovanni Battista Migliori, MD, WHO Collaborating Centre for TB and Lung Diseases, Fondazione S. Maugeri, Care and Research Institute, TBNET (TuBerculosis Network European Trials group) Secretariat, via Roncaccio 16, 21049 Tradate, Italy Fax: +39 0331829402; e-mail: firstname.lastname@example.org