Fayyaz Hussain.
Drug resistant TB.
Pak J Chest Med Jan ;7(Suppl):17-8.

One third of the world population is infected with TB bacillus. Since 1985 there has been a renewed epidemic of TB that was previously thought to be in check. There is evidence to believe the main factor for this resurgence has been the human immunodeficiency virus (HIV). In Pakistan the prevalence of TB, according to WHO estimate, is around 200/100 000 population. A recent study from a Pakistani rural area had shown that these WHO figures may be an under estimate. In the village studied the prevalence of smear positive and smear negative cases were found to be 554 and 1949/100 000 respectively. One major area of concern during this TB epidemic is the growing rate of drug resistance. The WHO in 1997 estimated that some 50 million people might be infected with drug resistant strains worldwide. The hardest hit areas were Russia, Central Africa, India, Pakistan, Thailand, and the Philippines. Drug resistant TB is entirely a manmade problem and results from inadequate chemotherapy. In community it is the chronic cases, resulting from poor treatment, that are the reservoir of deadly drug resistant strains of TB. The only way to prevent TB entirely is to effectively treat the active cases so as to stop the transmission of this infection in the community. Countries, like Pakistan, that do not have an active National TB Program are transforming an eminently treatable infection into a life threatening disease. Despite the availability of effective anti-TB drugs the severity of drug resistant TB has continued to increase worldwide and TB killed more people each year at the end of this century than it did in the beginning of this century. This is a review article.

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