Drug-resistant strains spreading globally
Dr. Juliet Melzer, MSF, Uzbekistan
”
The emergence and geographical spread of strains of TB that are resistant to treatment by the standard anti-TB drugs is a second major concern. Resistance to any one drug is the result of naturally occurring genetic mutation within the Mycobacterium, but resistance to multiple drugs emerges through incorrect, interrupted or frequently repeated treatment.
The WHO estimates that there are now almost 490,000 new cases of multidrug-resistant (MDR) TB every year, and that the amount of drug resistance has been ever-increasing in countries as diverse as Peru, South Africa, China and India.6 An estimated 120,000 people die annually from multidrug-resistant TB.7
Challenges multiplied
Diagnosis, treatment and prevention of drugsusceptible TB is difficult enough. But when it comes to tackling the disease in patients who are also infected with HIV or those with resistant strains of the disease, the medical challenges are multiplied.
© Mischa Friedman
In this document, through our work in Africa, the Caucasus and Asia, we illustrate our encounters with the
DR-TB patient, Russia
© Stephan Grosse Rueschkamp
“
We should understand that TB spares no one – there’s no single image today that represents the face of this disease. People think of TB as a disease primarily of men, of older people, of prisoners, but we have all sorts of people being treated here, all ages and from all walks of life, including a number of very young women.
new faces of TB and the tough challenges that we face in treating patients with drug-resistant TB and those infected with both TB and HIV. We also shed light on the limits of our capabilities, specifically linked to the continuing neglect of research into the development of newer and better vaccines, diagnostics and drugs to prevent, detect and treat tuberculosis.
Ulbosin, MDR-TB patient, Uzbekistan
What is TB?
Tuberculosis is a contagious airborne disease and spreads like a common cold. It is caused by a bacterium called Mycobacterium tuberculosis (or M. tuberculosis) which usually infects the lungs. Only one in ten people infected by the bacterium will actually develop the disease, since a healthy immune system will keep the infection dormant. But these infections can be reactivated years, even decades later, if the immune system is weak. This explains why people living with HIV whose immune system has been suppressed by the virus are so vulnerable to TB. The pulmonary form of TB is characterised by a persistent cough, shortness of breath and chest pain. Each person with the infectious form of TB, if untreated, will go on to infect between ten and 15 other people each year. The Mycobacterium can also infect almost any part of the body, such as the lymph nodes, the spine or bones. This is the extra-pulmonary form of TB, and is more common in HIV infected patients and children. Although extra-pulmonary TB may not be contagious, it is equally vital to diagnose and treat it rapidly, as all forms of the disease can be deadly if adequate treatment is not given.