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CDC HIV/AIDS/Viral Hepatitis/STD/TB Prevention News Update
GLOBAL: Surveillance of Anti-Tuberculosis Drug Resistance in the World: An Updated Analysis, 2007-2010
Matteo Zignol; Wayne van Gemert; Dennis Falzon; Charalambos
February 9, 2012
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."