Asian countries should strengthen health systems to address increasing drug-resistant tuberculosis

Mar 23 2009

World Health Organization officials on Monday ahead of World TB Day on March 24 said that Asian countries should increase efforts to strengthen health systems to address an increase in cases of drug-resistant tuberculosis, AFP/Google.com reports.

Pieter van Maaren, WHO regional adviser, said there were 112,000 recorded cases of drug-resistant TB in China in 2007 and that figures for 2008 likely will be similar. Van Maaren added that up to 6,000 new cases of drug-resistant TB are reported annually in the Philippines. In addition, Vietnam had between 3,000 and 4,000 new cases of multi-drug resistant TB in 2007, while Cambodia had fewer than 1,000 drug-resistant TB cases, van Maaren said, noting that exact figures are not available because many TB cases are undiagnosed. Van Maaren added that rates of drug-resistant TB are lower in Cambodia and Vietnam in part because of good TB control programs and the availability of TB drugs.

Van Maaren said drug-resistant TB is more difficult to diagnoses than drug-sensitive TB and that medicines to treat drug-resistant strains of the disease are costly and have more side effects. He added that drug-resistant TB is a "man-made problem caused by insufficient or inappropriate treatment, a result of patients stopping treatment before they are cured." Shin Young-Soo, WHO regional director for the Western Pacific region, added that effective TB control programs have been hindered by weaknesses in health systems, such as staff shortages and inadequate resources (AFP/Google.com, 3/23). A lack of sufficient funding, poor laboratory capacity, low access to health care, and inadequate links between providers in the public and private sectors also hamper TB control programs, WHO said. The organization added that a motivated workforce and the availability of no-cost TB treatment are fundamental to the success of TB control programs (Xinhuanet, 3/23).

"Our available tools work, but they are not enough," Shin said (AFP/Google.com, 3/23). "The risk of an epidemic of TB that does not respond to drugs compels countries to take action," Shin said, adding, "We cannot tackle MDR-TB when most laboratories lack sufficient number of skilled technicians, as well as the tools to identify cases" (Xinhuanet, 3/23).

TB Cases Increase in Singapore After 10 Years of Decline

In related news, the number of new TB cases in Singapore increased in 2008 for the first time in 10 years, the Ministry of Health said recently ahead of World TB Day, the Straits Times reports. According to the health ministry, there were 39.8 TB cases for every 100,000 people in 2008, up from 35.1 cases per 100,000 people in 2007. The number of TB patients increased by 15% from 1,256 in 2007 to 1,451 in 2008, the Times reports. TB incidence in Singapore had been declining annually since 1998, when the health ministry reported 57 TB cases per every 100,000 people (Lee, Straits Times, 3/23). The increase in new TB cases "is likely due to increased reactivation of latent TB infection as well as increased transmission of TB in the community," the health ministry said. According to the health ministry, a significant proportion of the new TB cases occurred among seniors and men (AFP/Independent Online, 3/23).