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Monday, March 26, 2007

Global TB rate stabilizes, XDR-TB remains high – WHO

The global rate of the world's deadliest curable infectious disease, tuberculosis has dropped, public health officials reported Thursday, offering a blink of hope for the first time since the World health Organization declared tuberculosis’ spread a public health emergency in 1993.

The latest statistics on tuberculosis, issued in a new Global Tuberculosis Control report Thursday from the World Health Organization, shows 136 TB cases per 100,000 people worldwide in 2005, the most recent figures available. That compares with 136.5 cases in year 2006, meaning the worldwide rate of tuberculosis has stabilized at about 136 cases per 100,000 people in the last two years. "This is a breakthrough," said Dr. Marcos Espinal of WHO's Stop TB Partnership. "It's the first time we've had good news about the epidemic since 1993." There were an estimated 8.7 million cases of the disease in 2005, killing an estimated 1.6 million people, 195,000 of them people living with HIV, WHO Director General Dr Margaret Chan said while issuing the report yesterday. "We need to tackle this problem as part of the larger challenge of increasing access to primary health care services", she stressed.

Although the announcement has offered a glimmer of hope for the organizations fighting against tuberculosis, but at the same time there is a bad news that the extensively drug resistant strain of tuberculosis, XDR-TB, rate has risen. The threat is emerging from drug-resistant versions of TB and the potential for its spread with the help of the AIDS epidemic. The AIDS virus weakens the immune system making people more susceptible to TB. The surge in the XDR-TB presents significant challenges to efforts to bring the global epidemic of ordinary TB under control, the World Health Organization (WHO) said yesterday. TB rates in the United States hit an all-time low in 2006, but health officials worry that progress to eliminate TB continued to slow. “Tuberculosis continues to have a significant and unacceptable impact on minorities and immigrant communities in the United States,” said Dr. Kevin Fenton, director of the federal Centers for Disease Control and Prevention’s National Center for HIV, STD and TB Prevention. The national TB case rate in 2006 was 4.6 TB cases per 100,000 Americans, the lowest since reporting began in 1953, the CDC reported yesterday. A total of 13,767 TB cases were reported last year in US, down from 14,085 cases in 2005.

While the Americas, South-East Asia and the Western pacific were on track to meet the target of the Global Plan to Stop TB, African, eastern Mediterranean and European regions were not, WHO said. According to the WHO's Western Pacific office in Manila, drug-resistant TB is now widespread in the Western Pacific region, with high levels documented in China, Mongolia and the Philippines. The deadly XDR-TB that swept through South Africa has engulfed at least 74 people in the last several months. Already hit by the HIV virus, South Africa was struck by the drug-resistant tuberculosis last year, with the TB rate of 343 cases per 100,000, more than twice the global rate.
Since then the health officials have urged for stronger measures to combat the strains, including better surveillance, diagnostics and drugs, in order to prevent it from transforming into a global pandemic. Tuberculosis or TB is an airborne bacillus caused by a bacterium called Mycobacterium tuberculosis that spreads through coughing or sneezing. It mainly affects the lung (80%) but can also affect most of other parts of the body except hair and nails. The other body parts which can come in grip of the disease are lymph nodes, gastro intestinal tract, genito-urinary tract, coverings of the brain (called meninges), linings of the lungs(pleura), heart(pericardium), brain, bones, joints, skin, eyes and other organs. Multidrug resistant TB (MDR TB) is a form of TB that is resistant to at least two first line therapies – isoniazid and rifampin, while extensively drug-resistant TB (XDR TB) develops from MDR-TB, and is resistant to at least isoniazid and rifampin among the first-line anti-TB drugs and among second-line drugs.

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