International public health officials have announced actions necessary to combat deadly new strains of tuberculosis that are resistant to most drugs on the market.
Officials from the South African Medical Research Council, the World Health Organization, and the Centers for Disease Control and Prevention called for rapid surveys of the prevalence of extensive drug-resistant TB in high-risk countries, increased laboratory capacity to carry out vital culture and drug resistance testing, improved clinical capacity, infection control precautions, and research support for new drug and diagnostic tests.
Of particular concern are countries with a high prevalence of HIV/AIDS, which public health officials warned has the potential to turn extensive drug-resistant TB into “an uncontrollable epidemic.” They called for universal access to antiretroviral drugs in joint TB/HIV projects.
Extensive or extreme drug-resistant TB describes strains that are resistant to the two most potent anti-TB drugs, isoniazid and rifampin, and at least three of six classes of second-line drugs.
International public health leaders gathered recently in Johannesburg in an emergency session with public health authorities from 11 southern African countries to discuss how to combat extensive drug-resistant TB.
“It is an area where the global community will need to be helpful to the countries that don't have resources, but locally, there needs to be ownership of the issue,” Ken Castro, director of the CDC's division of tuberculosis elimination, said in a press conference that was held in Johannesburg to discuss the threat of extensive drug-resistant TB.
New drugs and vaccines are in the works, officials said. Dr. Castro said that four agents look promising as drugs, but must still be proved through clinical trials.
Use of vaccines, including the BCG vaccine, is a possible approach, Dr. Castro said, although he added, “we will not be able to rely on vaccines to address the problem confronting us.”
Infection control in health care facilities is a priority, he said. To keep extensive drug-resistant TB from spreading to other patients, health care facilities need to promptly identify patients suffering from it, separate them from the rest of the patients, and make use of respiratory devices.