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Tomorrow - March 24th - is World TB Day, which commemorates the date 130 years ago (1882) when Dr. Robert Koch announced his discovery of the bacillus that causes tuberculosis; Mycobacterium tuberculosis.
Despite great advances made against this disease that began with the antibiotic era of the 1940s, in recent years we’ve seen the rise of new drug resistant strains of this killer disease.
Although the numbers continue to drop, in 2010 1.4 million deaths were attributed to this disease, and TB remains one of the three greatest causes of death of women (ages 14-44) in the world.
In the days leading up to this annual event we see a number of activities, publications, and conferences - and so today a roundup of just a few of them.
First stop, excerpts from an MMWR report issued yesterday by the CDC, called:
Trends in Tuberculosis — United States, 2011
Weekly
March 23, 2012 / 61(11);181-185What is already known on this topic?
Although tuberculosis (TB) has been on the decline in the United States since 1993, an increasing proportion of cases has been observed among the foreign-born. Racial and ethnic minorities have represented a higher proportion of cases among the U.S.-born.
What is added by this report?
Provisional 2011 surveillance data indicate a TB case rate of 3.4 cases per 100,000 persons, which is the lowest rate since 1993. For the first time since current reporting began in 1993, Asians have become the most widely represented racial/ethnic group among TB cases, even though case rates also have declined in this group. Reporting of human immunodeficiency (HIV) status at diagnosis has improved in the most recent reporting year, and HIV infection among TB cases is at an all-time low.
What are the implications for public health practice?
Continued awareness and surveillance of TB is needed despite the decline. Initiatives to improve awareness, testing, and treatment of latent infection and TB disease in minorities and foreign-born populations should facilitate progress toward the elimination of TB in the United States.
FIGURE 1. Rate* of tuberculosis cases — United States, 2011†
* Per 100,000 population.
For a listing of events and activities that the CDC and its domestic and international partners will be conducting, you can visit their World TB Day 2012 webpage.
Next stop, from the Health Protection Agency, which has released a report indicating that the number of new TB cases in the UK increased by 5% in 2011.
More than 9,000 TB cases reported in 2011
23 March 2012
Provisional figures released today by the Health Protection Agency (HPA) show there were 9,042 new cases of tuberculosis (TB) in the UK in 2011. Compared to provisional numbers reported in 2010 (8,587), this is a five per cent increase.
The figures, released in the HPA’s annual TB newsletter ahead of World TB Day on Saturday 24 March, show the main burden of this infection is still in London with 3,588 cases reported in 2011, accounting for 40 per cent of the UK total. According to the provisional data, country of origin was recorded in 8,453 new cases, and almost three quarters (6,270) were in non-UK born people.
Earlier this week (see link) the ECDC released a New ECDC-WHO report: tuberculosis on the retreat in Europe but concerns about drug-resistant TB and treatment failure remain.
And from the World Health Organization today, as one would expect, a number of items, including this media release on the need for better diagnostics and research on drug resistant TB.
More evidence and better diagnostics needed before redefining severe forms of drug-resistant TB says WHO
Note for the media
23 March 2012 | Geneva - Reports of tuberculosis (TB) cases with severe patterns of drug resistance are increasing, said experts who attended a WHO meeting in Geneva on 21-22 March. Participants stressed that the emergence of drug resistance should be a wake-up call for Ministries of Health. The group urged the global TB community to make greater efforts to prevent drug resistance and scale up provision of appropriate care and management to avoid a scenario where TB becomes incurable.
Insufficient evidence
The meeting concluded that there is currently insufficient evidence to adopt new case definitions for drug-resistant TB. Drug susceptibility testing (DST), which is key to defining new levels of drug resistance, lacks accuracy for several of the drugs that are used to treat multi drug-resistant (MDR) and extensively drug resistant (XDR)-TB. Secondly, there is insufficient correlation of DST results with clinical response to treatment for several drugs currently used to treat XDR-TB. Thirdly, new drugs are currently undergoing clinical trials, and could prove effective against drug resistant strains. The meeting urged diagnostics companies and TB laboratories to develop better diagnostic tests and also agreed that WHO and technical partners should develop more detailed guidance on XDR-TB treatment.
Prior to results from randomized controlled trials, which are not expected for at least four years, participants called on WHO to lead a process with partners to improve the quality and quantity of observational data on the management of cases of severe forms of drug resistance. These data should be collected in a standardized manner which is essential for stronger future policy decisions on the management of drug resistant TB.
And to finish off, some World TB Day links from the WHO:
World TB Day site
WHO programme on TB
Stop TB Partnership
More about tuberculosis
