Drug Resistant Tuberculosis in China

I’ve talked about multi-drug resistant tuberculosis on this site before, but I want to return to the topic because of some recent articles on the topic covered on NPR. Last year there was some good news about tuberculosis globally, as researchers found that the total number of cases was declining, particularly in China. A new national tuberculosis survey in China this year, however, reveals that 10% of all new cases of tuberculosis diagnosed that country are multi-drug resistant, while 8% of these cases were infected with XDR, or extensively drug resistant tuberculosis. For these people, the treatment options are limited, and may not be successful. The article in the New England Journal of Medicine described the problems within the Chinese health care system that are driving this problem. But these challenges sound very similar to difficulties in other nations, including India and South Africa …

Totally Drug Resistant Tuberculosis

In our book and this blog we give considerable attention to the threat posed by avian influenza, which also attracts a great deal of media coverage. But there is another, and older, threat that also deserves attention. Tuberculosis has been a growing problem. As Paul Farmer’s work has described, it flourished in Russia after the collapse of the Soviet Union, and drug resistant tuberculosis has been a growing threat from Peru to Haiti. The challenge is that if patients are not properly diagnosed, or if they fail to take a long course (a minimum of six months) of medication, the disease becomes resistant.

"Bacteria" by ddpavumba at

This problem has combined with the spread of HIV/AIDS, which decreases people’s resistance to TB. This led to a terrifying outbreak in KwaZulu-Natal province of South Africa, where an epidemic of extensively drug resistant (XDR) tuberculosis (TB) began spreading in 2006. From South Africa, the disease was moved into neighboring countries, such as Lesotho.

A recent news article in South Africa gives some insight into why TB was so difficult to treat. After a woman was diagnosed with XDR TB, she required intensive, inpatient care. Her family had to conduct a (successful) fund-raising campaign before she could be admitted to a hospital, where she is finally receiving the care she needs. In this case, the woman’s family rose to the challenge, and obtained care for her. But what if she had not been so fortunate? …

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