From mono, multiple to extensive drug resistant TB: Where are we heading for?

S.A. Khan, S.D. Chundru, G.S. Rodrigues, N. Pokharel, P.S. Kansakar

Research output: Contribution to journalArticle

Abstract

Background: A short course of antitubercular drugs in 1960s offered the prospect of eradicating this disease. By late 1980s HIV pandemic lead to a rapid upsurge of tuberculosis (TB) and shattered this hope. In the 1990s, multidrug-resistant (MDR) tuberculosis received widespread attention and in this present decade, we are heading towards an emergence of extensively drug-resistant (XDR) TB and adding a new chapter to the history of this disease. Methods: The emergence of XDR-TB, spread and the reasons for its emergence was studied from the available and published literature from January 1996 till December 2006. Search strategy involved primary, secondary literatures with search term: XDR-TB, spread of XDR-TB. Official websites of WHO and Global TB Alliance were also accessed for latest updates. Data extraction was independently done by the authors. Available relevant information was pooled and arranged with respect to XDR-TB emergence, reasons, clinical studies and preventive measures. Current status on anti-TB drug research was also looked into. Results: A total of 14 articles were obtained. However, these were clinical studies from single or multicenters highlighting the incidence of XDR-TB. Information on reasons for drug resistance, preventive measures, status in developing countries were obtained from WHO website. Global TB Alliance mentioned only 3 compounds under clinical testing against TB. Major causes for XDR-TB emergence included an incorrect prescription of drug regimens, poor drug quality, erratic drug supply, non-adherence by patients and poor infection control. Conclusion: XDR-TB has emerged due to negligent case-management and poorly functioning public-health services. An acquisition and transmission of drug-resistant strains add to their incidence. However till date the overall incidence is arguably infrequent. The real problem from a public-health perspective therefore is to prevent transmission of resistant strains. The need of the hour is to gear up a sound public-health practice. Major attention to issues like research in developing safe and effective newer anti-TB compounds, which should be made available at an economical rate, is what we recommend. © 2007 - IOS Press and the authors. All rights reserved.
Original languageEnglish
Pages (from-to)179-185
Number of pages7
JournalInternational Journal of Risk and Safety in Medicine
Volume19
Issue number4
Publication statusPublished - 2007

Fingerprint

Multidrug-Resistant Tuberculosis
Tuberculosis
Pharmaceutical Preparations
Incidence
Hope
Extensively Drug-Resistant Tuberculosis
Antitubercular Agents
Public Health Practice
United States Public Health Service
Prescription Drugs
Case Management
Pandemics
Patient Compliance
Infection Control
Research
Drug Resistance
Developing Countries

Cite this

Khan, S.A. ; Chundru, S.D. ; Rodrigues, G.S. ; Pokharel, N. ; Kansakar, P.S. / From mono, multiple to extensive drug resistant TB: Where are we heading for?. In: International Journal of Risk and Safety in Medicine. 2007 ; Vol. 19, No. 4. pp. 179-185.
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title = "From mono, multiple to extensive drug resistant TB: Where are we heading for?",
abstract = "Background: A short course of antitubercular drugs in 1960s offered the prospect of eradicating this disease. By late 1980s HIV pandemic lead to a rapid upsurge of tuberculosis (TB) and shattered this hope. In the 1990s, multidrug-resistant (MDR) tuberculosis received widespread attention and in this present decade, we are heading towards an emergence of extensively drug-resistant (XDR) TB and adding a new chapter to the history of this disease. Methods: The emergence of XDR-TB, spread and the reasons for its emergence was studied from the available and published literature from January 1996 till December 2006. Search strategy involved primary, secondary literatures with search term: XDR-TB, spread of XDR-TB. Official websites of WHO and Global TB Alliance were also accessed for latest updates. Data extraction was independently done by the authors. Available relevant information was pooled and arranged with respect to XDR-TB emergence, reasons, clinical studies and preventive measures. Current status on anti-TB drug research was also looked into. Results: A total of 14 articles were obtained. However, these were clinical studies from single or multicenters highlighting the incidence of XDR-TB. Information on reasons for drug resistance, preventive measures, status in developing countries were obtained from WHO website. Global TB Alliance mentioned only 3 compounds under clinical testing against TB. Major causes for XDR-TB emergence included an incorrect prescription of drug regimens, poor drug quality, erratic drug supply, non-adherence by patients and poor infection control. Conclusion: XDR-TB has emerged due to negligent case-management and poorly functioning public-health services. An acquisition and transmission of drug-resistant strains add to their incidence. However till date the overall incidence is arguably infrequent. The real problem from a public-health perspective therefore is to prevent transmission of resistant strains. The need of the hour is to gear up a sound public-health practice. Major attention to issues like research in developing safe and effective newer anti-TB compounds, which should be made available at an economical rate, is what we recommend. {\circledC} 2007 - IOS Press and the authors. All rights reserved.",
author = "S.A. Khan and S.D. Chundru and G.S. Rodrigues and N. Pokharel and P.S. Kansakar",
note = "Export Date: 10 November 2017 CODEN: IJMDE Correspondence Address: Khan, S.A.; Dept. of Pharmacy Practice, S. S. Cancer Hosp. and Research Centre, Manipal - 576 104, Karnataka, India; email: sohailkhan1981@gmail.com References: De Cock, K.M., Chaisson, R.E., Will DOTS do it? A reappraisal of tuberculosis control in countries with high rates of HIV infection (1999) Int. J. Tuberc. Lung Dis, 3, pp. 457-465; Dye, C., Scheele, S., Dolin, P., Pathania, V., Raviglione, M.C., Consensus statement. Global burden of tuberculosis: Estimated incidence, prevalence, and mortality by country. WHO Global Surveillance and Monitoring Project (1999) JAMA, 282, pp. 677-686; Emergence of mycobacterium tuberculosis with extensive resistance to second-line drugs worldwide, 2000-2004 (2006) MMWR Morb. Mortal Wkly Rep, 55, pp. 301-305; Gandhi, N.R., Moll, A., Sturm, A.W., Pawinski, R., Govender, T., Lalloo, U., Zeller, K., Friedland, G., Extensively drug-resistant tuberculosis as a cause of death in patients co-infected with tuberculosis and HIV in a rural area of South Africa (2006) Lancet, 368, pp. 1575-1580; Keshavjee, S., Becerra, M.C., Disintegrating health services and resurgent tuberculosis in post-Soviet Tajikistan: An example of structural violence (2000) JAMA, 283, p. 1201; Masjedi, M.R., Farnia, P., Sorooch, S., Pooramiri, M.V., Mansoori, S.D., Zarifi, A.Z., Akbarvelayati, A., Hoffner, S., Extensively drug-resistant tuberculosis: 2 years of surveillance in Iran (2006) Clin. Infect. Dis, 43, pp. 841-847; Available at www.nacoonline.org (2006) Accessed on 10th December, , National AIDS Control Organisation NACO; Paul, D., Helden, V., Tommie, V., The source of drug resistant TB outbreaks (2006) Science, 314, pp. 420-421; (2006) Report from the Expert Consultation on Drug Resistant Tuberculosis, , http://www.who.int/tb/kg1/en/index.html, Johannesburg, South Africa, 7-8 September, Available at, Accessed on 10th December 2006; The Global Alliance for TB Drug Development, Available at www.new.tballiance.org/ newscenter/publications.php (2006) Accessed on 14th December, , Scientific Blueprint for Tuberculosis drug development; Stephen, D.L., Robert, W., Extensively drug resistant tuberculosis (2006) BMJ, 333, pp. 559-560; TB Alliance, Global Alliance for TB Drug Development (2006) Annual Report, , www.tballiance.org/downloads/publications/TBA_Annual_2005- 06.pdf, Available at, Accessed on 14th December 2006; Van, A.R., Donald, E., XDR tuberculosis: An indicator of public-health negligence (2006) Lancet, 368, pp. 1554-1556; Emergence of XDR-TB: WHO concern over extensive drug resistant TB strains that are virtually untreatable, Available at www.who.int/tb/ publications/WHO emergence of XDR-TB.htm (2006) Accessed on 10th December, , WHO; (2006) Global tuberculosis control - surveillance, planning, financing, , www.who.int/tb/publications/global_report/2005, WHO, Available at, Accessed on 12th December; Zignol, M., Hosseini, K.S., Wright, A., Global incidence of multidrug-resistant tuberculosis (2006) J. Infect. Dis, 194, pp. 479-485",
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From mono, multiple to extensive drug resistant TB: Where are we heading for? / Khan, S.A.; Chundru, S.D.; Rodrigues, G.S.; Pokharel, N.; Kansakar, P.S.

In: International Journal of Risk and Safety in Medicine, Vol. 19, No. 4, 2007, p. 179-185.

Research output: Contribution to journalArticle

TY - JOUR

T1 - From mono, multiple to extensive drug resistant TB: Where are we heading for?

AU - Khan, S.A.

AU - Chundru, S.D.

AU - Rodrigues, G.S.

AU - Pokharel, N.

AU - Kansakar, P.S.

N1 - Export Date: 10 November 2017 CODEN: IJMDE Correspondence Address: Khan, S.A.; Dept. of Pharmacy Practice, S. S. Cancer Hosp. and Research Centre, Manipal - 576 104, Karnataka, India; email: sohailkhan1981@gmail.com References: De Cock, K.M., Chaisson, R.E., Will DOTS do it? A reappraisal of tuberculosis control in countries with high rates of HIV infection (1999) Int. J. Tuberc. Lung Dis, 3, pp. 457-465; Dye, C., Scheele, S., Dolin, P., Pathania, V., Raviglione, M.C., Consensus statement. Global burden of tuberculosis: Estimated incidence, prevalence, and mortality by country. WHO Global Surveillance and Monitoring Project (1999) JAMA, 282, pp. 677-686; Emergence of mycobacterium tuberculosis with extensive resistance to second-line drugs worldwide, 2000-2004 (2006) MMWR Morb. Mortal Wkly Rep, 55, pp. 301-305; Gandhi, N.R., Moll, A., Sturm, A.W., Pawinski, R., Govender, T., Lalloo, U., Zeller, K., Friedland, G., Extensively drug-resistant tuberculosis as a cause of death in patients co-infected with tuberculosis and HIV in a rural area of South Africa (2006) Lancet, 368, pp. 1575-1580; Keshavjee, S., Becerra, M.C., Disintegrating health services and resurgent tuberculosis in post-Soviet Tajikistan: An example of structural violence (2000) JAMA, 283, p. 1201; Masjedi, M.R., Farnia, P., Sorooch, S., Pooramiri, M.V., Mansoori, S.D., Zarifi, A.Z., Akbarvelayati, A., Hoffner, S., Extensively drug-resistant tuberculosis: 2 years of surveillance in Iran (2006) Clin. Infect. Dis, 43, pp. 841-847; Available at www.nacoonline.org (2006) Accessed on 10th December, , National AIDS Control Organisation NACO; Paul, D., Helden, V., Tommie, V., The source of drug resistant TB outbreaks (2006) Science, 314, pp. 420-421; (2006) Report from the Expert Consultation on Drug Resistant Tuberculosis, , http://www.who.int/tb/kg1/en/index.html, Johannesburg, South Africa, 7-8 September, Available at, Accessed on 10th December 2006; The Global Alliance for TB Drug Development, Available at www.new.tballiance.org/ newscenter/publications.php (2006) Accessed on 14th December, , Scientific Blueprint for Tuberculosis drug development; Stephen, D.L., Robert, W., Extensively drug resistant tuberculosis (2006) BMJ, 333, pp. 559-560; TB Alliance, Global Alliance for TB Drug Development (2006) Annual Report, , www.tballiance.org/downloads/publications/TBA_Annual_2005- 06.pdf, Available at, Accessed on 14th December 2006; Van, A.R., Donald, E., XDR tuberculosis: An indicator of public-health negligence (2006) Lancet, 368, pp. 1554-1556; Emergence of XDR-TB: WHO concern over extensive drug resistant TB strains that are virtually untreatable, Available at www.who.int/tb/ publications/WHO emergence of XDR-TB.htm (2006) Accessed on 10th December, , WHO; (2006) Global tuberculosis control - surveillance, planning, financing, , www.who.int/tb/publications/global_report/2005, WHO, Available at, Accessed on 12th December; Zignol, M., Hosseini, K.S., Wright, A., Global incidence of multidrug-resistant tuberculosis (2006) J. Infect. Dis, 194, pp. 479-485

PY - 2007

Y1 - 2007

N2 - Background: A short course of antitubercular drugs in 1960s offered the prospect of eradicating this disease. By late 1980s HIV pandemic lead to a rapid upsurge of tuberculosis (TB) and shattered this hope. In the 1990s, multidrug-resistant (MDR) tuberculosis received widespread attention and in this present decade, we are heading towards an emergence of extensively drug-resistant (XDR) TB and adding a new chapter to the history of this disease. Methods: The emergence of XDR-TB, spread and the reasons for its emergence was studied from the available and published literature from January 1996 till December 2006. Search strategy involved primary, secondary literatures with search term: XDR-TB, spread of XDR-TB. Official websites of WHO and Global TB Alliance were also accessed for latest updates. Data extraction was independently done by the authors. Available relevant information was pooled and arranged with respect to XDR-TB emergence, reasons, clinical studies and preventive measures. Current status on anti-TB drug research was also looked into. Results: A total of 14 articles were obtained. However, these were clinical studies from single or multicenters highlighting the incidence of XDR-TB. Information on reasons for drug resistance, preventive measures, status in developing countries were obtained from WHO website. Global TB Alliance mentioned only 3 compounds under clinical testing against TB. Major causes for XDR-TB emergence included an incorrect prescription of drug regimens, poor drug quality, erratic drug supply, non-adherence by patients and poor infection control. Conclusion: XDR-TB has emerged due to negligent case-management and poorly functioning public-health services. An acquisition and transmission of drug-resistant strains add to their incidence. However till date the overall incidence is arguably infrequent. The real problem from a public-health perspective therefore is to prevent transmission of resistant strains. The need of the hour is to gear up a sound public-health practice. Major attention to issues like research in developing safe and effective newer anti-TB compounds, which should be made available at an economical rate, is what we recommend. © 2007 - IOS Press and the authors. All rights reserved.

AB - Background: A short course of antitubercular drugs in 1960s offered the prospect of eradicating this disease. By late 1980s HIV pandemic lead to a rapid upsurge of tuberculosis (TB) and shattered this hope. In the 1990s, multidrug-resistant (MDR) tuberculosis received widespread attention and in this present decade, we are heading towards an emergence of extensively drug-resistant (XDR) TB and adding a new chapter to the history of this disease. Methods: The emergence of XDR-TB, spread and the reasons for its emergence was studied from the available and published literature from January 1996 till December 2006. Search strategy involved primary, secondary literatures with search term: XDR-TB, spread of XDR-TB. Official websites of WHO and Global TB Alliance were also accessed for latest updates. Data extraction was independently done by the authors. Available relevant information was pooled and arranged with respect to XDR-TB emergence, reasons, clinical studies and preventive measures. Current status on anti-TB drug research was also looked into. Results: A total of 14 articles were obtained. However, these were clinical studies from single or multicenters highlighting the incidence of XDR-TB. Information on reasons for drug resistance, preventive measures, status in developing countries were obtained from WHO website. Global TB Alliance mentioned only 3 compounds under clinical testing against TB. Major causes for XDR-TB emergence included an incorrect prescription of drug regimens, poor drug quality, erratic drug supply, non-adherence by patients and poor infection control. Conclusion: XDR-TB has emerged due to negligent case-management and poorly functioning public-health services. An acquisition and transmission of drug-resistant strains add to their incidence. However till date the overall incidence is arguably infrequent. The real problem from a public-health perspective therefore is to prevent transmission of resistant strains. The need of the hour is to gear up a sound public-health practice. Major attention to issues like research in developing safe and effective newer anti-TB compounds, which should be made available at an economical rate, is what we recommend. © 2007 - IOS Press and the authors. All rights reserved.

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JO - International Journal of Risk and Safety in Medicine

JF - International Journal of Risk and Safety in Medicine

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