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. 2015 Jan;45(1):150-60.
doi: 10.1183/09031936.00101814. Epub 2014 Sep 26.

Multidrug-resistant tuberculosis around the world: what progress has been made?

Dennis Falzon  1 , Fuad Mirzayev  2 , Fraser Wares  2 , Inés Garcia Baena  2 , Matteo Zignol  2 , Nguyen Linh  2 , Karin Weyer  2 , Ernesto Jaramillo  2 , Katherine Floyd  2 , Mario Raviglione  2
Affiliations
Free PMC article

Multidrug-resistant tuberculosis around the world: what progress has been made?

Dennis Falzon et al. Eur Respir J. 2015 Jan.
Free PMC article

Abstract

Multidrug-resistant tuberculosis (MDR-TB) (resistance to at least isoniazid and rifampicin) will influence the future of global TB control. 88% of estimated MDR-TB cases occur in middle- or high-income countries, and 60% occur in Brazil, China, India, the Russian Federation and South Africa. The World Health Organization collects country data annually to monitor the response to MDR-TB. Notification, treatment enrolment and outcome data were summarised for 30 countries, accounting for >90% of the estimated MDR-TB cases among notified TB cases worldwide. In 2012, a median of 14% (interquartile range 6-50%) of estimated MDR-TB cases were notified in the 30 countries studied. In 15 of the 30 countries, the number of patients treated for MDR-TB in 2012 (71 681) was >50% higher than in 2011. Median treatment success was 53% (interquartile range 40-70%) in the 25 countries reporting data for 30 021 MDR-TB cases who started treatment in 2010. Although progress has been noted in the expansion of MDR-TB care, urgent efforts are required in order to provide wider access to diagnosis and treatment in most countries with the highest burden of MDR-TB.

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Conflict of interest statement

Conflict of interest: None declared.

Figures

FIGURE 1
FIGURE 1
a) New and b) retreatment tuberculosis cases with drug-susceptibility test results for isoniazid and rifampicin, 2012, by country. Inadequate linkage between clinical and laboratory registers may result in an overestimation of drug-susceptibility testing coverage (e.g. >100% in Kazakhstan).
FIGURE 2
FIGURE 2
Multidrug-resistant tuberculosis (MDR-TB) cases and additional rifampicin-resistant TB cases detected, compared with TB cases enrolled on MDR-TB treatment, trend in target countries, 2009−2012.
FIGURE 3
FIGURE 3
Treatment outcomes for patients diagnosed with multidrug-resistant tuberculosis by target country, 2007−2010 cohorts. The total number of cases in each annual cohort is shown on the bars.
FIGURE 4
FIGURE 4
Multidrug-resistant tuberculosis (MDR-TB) notifications and percentage of funding received for second-line drugs from external sources, by income group, 2012. a) high-income group; b) upper middle-income group; c) lower middle-income group; d) low-income group. Only countries that reported data for both domestic and external funding are shown.
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