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Epidemiology of multidrug-resistant tuberculosis in low- and middle-income countries

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Book cover Multidrug-resistant Tuberculosis

Part of the book series: Resurgent and Emerging Infectious Diseases ((REID,volume 1))

Abstract

Drug-resistant tuberculosis (TB) was reported soon after the introduction of streptomycin [1], although it did not receive major attention until recently [2,3]. It was not considered a major issue in the industrialized world until outbreaks of multidrug-resistant TB (MDRTB), defined as resistance to at least isoniazid and rifampicin, were reported among HIV-infected people [4– 7]. There has been an increasing concern on how drug-resistant TB and, more specifically, MDRTB is, or will be, negatively affecting TB control activities [8,9]. Since rifampicin and isoniazid are the most powerful firstline anti-TB drugs, it would be fair to assume that if MDRTB reaches significant levels in a given country, control efforts would fail to achieve their main goal: the decline of TB incidence by reducing Mycobacterium tuberculosis (M. tuberculosis) transmission through the cure of TB cases. Administration of standard short-course chemotherapy (SSCC) with firstline drugs (isoniazid, rifampicin, streptomycin, ethambutol, pyrazinamide, and thioacetazone) under directly observed therapy (DOT) is the cornerstone of modern TB control. Unfortunately, data available on the treatment outcome of MDRTB cases under routine programmatic conditions suggest that patients with MDRTB respond poorly to SSCC with first-line drugs [10].

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Authors and Affiliations

  1. Drug Resistance Surveillance Team, Communicable Diseases Surveillance and Response, World Health Organization, Geneva, Switzerland

    Marcos A. Espinal

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  1. Marcos A. Espinal
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Editors and Affiliations

  1. Mycobacterium Reference Laboratory, Institute of Medical & Veterinary Science, Adelaide, Australia

    Ivan Bastian

  2. Mycobacteriology Unit, Institute of Tropical Medicine, Antwerp, Belgium

    Françoise Portaels

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Espinal, M.A. (2000). Epidemiology of multidrug-resistant tuberculosis in low- and middle-income countries. In: Bastian, I., Portaels, F. (eds) Multidrug-resistant Tuberculosis. Resurgent and Emerging Infectious Diseases, vol 1. Springer, Dordrecht. https://doi.org/10.1007/978-94-011-4084-3_3

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  • DOI: https://doi.org/10.1007/978-94-011-4084-3_3

  • Publisher Name: Springer, Dordrecht

  • Print ISBN: 978-94-010-5794-3

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