Bulletin of the World Health Organization Vol. 90; No. 2: doi:
In order to present a global update on drug-resistant TB and
explore trends in 1994-2010, the researchers analyzed data on
drug resistance among new and previously treated TB patients,
as reported by countries to the World Health Organization.
These data are collected through surveys of a representative
sample of TB patients or surveillance systems based upon
routine drug susceptibility testing. Logistic regression was
used to explore associations between multidrug-resistant TB
(MDR TB) and HIV infection and sex.
Eighty nations and eight territories reported surveillance
data in 2007-2010. MDR TB among new and previously treated
patients was highest in the Russian Federation (Murmansk
oblast, 28.9 percent) and the Republic of Moldova (65.1
percent), respectively. More than 10 percent of MDR TB cases
were extensively drug-resistant in three former Soviet Union
countries and South Africa.
Globally from 1994 to 2010, multidrug resistance was seen in
3.4 percent of all new TB cases (95 percent confidence
interval: 1.9-5.0) and 19.8 percent of previously treated TB
cases (95 percent CI: 14.4-25.1). No overall associations were
found between MDR TB and HIV (odds ratio: 1.4; 95 percent CI:
0.7-3.0) or sex (OR: 1.1; 95 percent CI 0.8-1.4). During 1994-
2010, MDR TB rates among the general population increased in
Botswana, Peru, and the Republic of Korea; they declined in
Estonia, Latvia, and the United States.
"The highest global rates of MDR TB ever reported were
documented in 2009 and 2010," the authors concluded. "Trends
in MDR TB are still unclear in most settings. Better
surveillance or survey data are required, especially from
Africa and India."