Epidemiology of multidrug-resistant, extensively drug resistant, and totally drug resistant tuberculosis in Middle East countries

Abstract

The 2015 represent the deadline for the global tuberculosis (TB) targets set through the Millennium Development Goals (MDG). From 2016 and onward, new goals were set to end the global TB epidemic via implementing new campaign entitled "the End TB Strategy". The major hurdle to end TB epidemic in several parts of the world is the emergence and spread of drug resistant Mycobacterium tuberculosis (MTB) strains. The better understanding of the actual global burden of drug resistant tuberculosis would feed into better implementing the End TB Strategy. In this article we summarize the current knowledge on the patterns of drug resistance tuberculosis cases in the Middle East countries. These countries are served by the Eastern Mediterranean Regional Office (EMRO), one out of six regional offices of World Health Organization. Middle East countries are characterized by geographic vicinity and population's interaction. However, they are dissimilar in several aspects such as economy and health infrastructures. Regarding economy, countries in this region are ranging from wealthy to very poor. Prevalence of tuberculosis and patterns drug resistance tuberculosis cases are also following variable trends within countries of this region. In almost all Middle East countries, there is under-reporting of drug-resistance tuberculosis cases. There are shortages in the infrastructures and facilities for detecting the pattern of drug-resistance tuberculosis. For instance, sixout of 14 countries have neither in-country capacity nor a linkage with a partner laboratory for second-line drug susceptibility testing and only 4 countries have registered site performing Xpert MTB/RIF.

Evaluation of Direct Colorimetric MTT Assay for Rapid Detection of Rifampicin and Isoniazid Resistance in Mycobacterium tuberculosis

“…tuberculosis ) strains resistant to at least isoniazid and rifampicin, defined as multidrug-resistant tuberculosis (MDR-TB), is a serious cause for concern to TB control programs particularly in low-income countries. The spread of drug-resistant TB significantly worsens the prognosis for achieving a durable cure, presages treatment failure and prolongs the period of transmission potential [1]. Worldwide, the annual MDR-TB burden is estimated at around 500 000 cases or 3.6% of the global TB burden [2].…”

How Long Does Antimycobacterial Antibiotic-loaded Bone Cement Have In Vitro Activity for Musculoskeletal Tuberculosis?

“…Finally, only one kind of susceptible Mycobacterium tuberculosis was evaluated in this study. In several countries, diverse resistant strains including strains with extended drug resistance or total drug resistance have been reported, and it is challenging to achieve successful prevention and treatment when confronted with these resistant strains [3,43,[47][48][49]. However, the prevalence of the susceptible mycobacterium strain remains considerable [21,27,28,36], therefore our investigation of this susceptible strain is clinically relevant.…”

Evaluation of risk factors associated with drug-resistant tuberculosis in Yemen: data from centres with high drug resistance

“…Factors such as limited availability of free and second-line drugs in developing countries such as Yemen, a prolonged duration of treatment, high prices, treatment-associated toxicity, the lack of specialists and laboratory facilities, and the practice of selling second-line TB drugs in private sectors hinder the effective characterisation of treatment outcomes of drug resistance therapy [7–11]. Because of the civil war in Yemen, conditions have recently worsened, and information regarding MDR-TB is scarce.…”