Multidrug- and extensively drug-resistant tuberculosis in Africa and South America: epidemiology, diagnosis and management in adults and children.
Available data show that Africa, together with the Americas and western and central Europe, reported the lowest prevalence of multidrug-resistant tuberculosis (MDR-TB). However, sub-Saharan Africa has a high TB incidence and the highest human immunodeficiency virus (HIV) prevalence in the world, and because of the high number of TB cases, Africa still presents 14% of the global burden of new MDR-TB cases. Until recently, Africa and South America were deprived of second-line antituberculosis drugs, preventing the development of extensively drug-resistant TB (XDR-TB). Current efforts, introducing improved laboratory infrastructure and second-line TB treatment in resource-limited countries, need to be carried out with care to minimize the development of MDR/XDR-TB in these countries. Recent diagnostic developments now need evaluation and implementation in resource-limited areas, and delays in diagnosis also need to be addressed. Outcomes for MDR/XDR-TB have improved, but prevention of MDR/XDR-TB by early diagnosis and treatment, improvement of adherence, and proper infection control remains the mainstay for the future.
Schaaf
H Simon
HS
Desmond Tutu TB Centre, Department of Paediatrics and Child Health, Faculty of Health Sciences, Stellenbosch University, and Tygerberg Children's Hospital, PO Box 19063, Tygerberg 7505, South Africa. hss@sun.ac.za
Moll
Anthony P
AP
Dheda
Keertan
K
D000328:Adult; D000349:Africa / Q000453:epidemiology; D000995:Antitubercular Agents / Q000627:therapeutic use*; D002648:Child; D054908:Extensively Drug-Resistant Tuberculosis / Q000175:diagnosis / Q000188:drug therapy / Q000453:epidemiology; D006801:Humans; D015994:Incidence; D009169:Mycobacterium tuberculosis / Q000187:drug effects* / Q000302:isolation & purification; D011159:Population Surveillance / Q000379:methods*; D015995:Prevalence; D013020:South America / Q000453:epidemiology
D000995:Antitubercular Agents