Global incidence of multidrug-resistant tuberculosis.
BACKGROUND
The global number of incident cases of multidrug-resistant (MDR) tuberculosis (TB) in 2000 was estimated to be 272,906 (95% confidence interval [CI], 184,948-414,295). For accurate planning of TB control programs, this estimate and others have been revised using data from additional countries and by including in the model previously treated TB cases, which had not been accounted for in the previous analysis.


METHODS
Multiple logistic regression was used to identify variables that were predictive of MDR-TB frequency among new and previously treated cases surveyed in 90 and 77 countries, respectively. These variables were then used to estimate MDR-TB frequencies in countries that had not been surveyed.


RESULTS
The total number of MDR-TB cases estimated to have occurred worldwide in 2004 is 424,203 (95% CI, 376,019-620,061), or 4.3% (95% CI, 3.8%-6.1%) of all new and previously treated TB cases. In the same year, 181,408 (95% CI, 135,276-319,017) MDR-TB cases were estimated to have occurred among previously treated TB cases alone. Three countries--China, India, and the Russian Federation--accounted for 261,362 (95% CI, 180,779-414,749) MDR-TB cases, or 62% of the estimated global burden.


CONCLUSIONS
These updated sets of estimates incorporating previously treated TB cases call for an urgent plan to expand appropriate diagnostic and treatment services for patients with MDR-TB in low-resource settings.
Zignol
Matteo
M
Stop TB Department, World Health Organization, Geneva 1211, Switzerland. zignolm@who.int
Hosseini
Mehran S
MS
Wright
Abigail
A
Weezenbeek
Catharina Lambregts-van
CL
Nunn
Paul
P
Watt
Catherine J
CJ
Williams
Brian G
BG
Dye
Christopher
C
D014943:Global Health; D006285:Health Planning; D006801:Humans; D015994:Incidence; D016015:Logistic Models; D015233:Models, Statistical; D018088:Tuberculosis, Multidrug-Resistant / Q000453:epidemiology* / Q000382:microbiology / Q000517:prevention & control*