scholarly journals Transregional movement of multidrug-resistant tuberculosis in north China: an underlying threat to tuberculosis control

2016 ◽  
Vol 6 (1) ◽  
Author(s):  
Jun An ◽  
Mengqiu Gao ◽  
Naihui Chu ◽  
Hairong Huang ◽  
Yu Pang ◽  
...  
2021 ◽  
Vol 8 (2) ◽  
pp. 16-27
Author(s):  
N.A. Pavluchenkova ◽  
A.V. Mikheeva ◽  
E.A. Sakharitova

The spread of multidrug-resistant and extensively drug-resistant tuberculosis (MDR and XDR) requires the search and implementation of not only new diagnostic methods, but also innovations in the treatment of the disease. Aim. The assessment of current treatment options for multidrug-resistant tuberculosis in different countries. Materials and Methods. There was carried out the content analysis of the official sources of 24 countries concerning the drugs that had been registered at these countries and recommended by the World Health Organization for the treatment of multidrug-resistant tuberculosis and put into circulation from 2000 to 2020: linezolid, bedaquiline, delamanid, clofazimine (as of 07.2020). The data were compared with the characteristics of the epidemiological situation in the country. Results. There was developed a six-digit classification by the following criteria: the presence of international nonproprietary names for drugs; the availability and range of dosage forms; the number of drugs subject to all dosage forms, dosages, pharmaceutical forms and units of packaging; the presence in the domestic market of the original product; the time of registration of drugs in the specified territory; the level of multi-drug resistance of the pathogen in the country per 100,000 population. Among the countries with the highest market coverage with a low (up to 0.5 per 100 thousand) level of multidrug resistance, a large share falls on European countries. As for a number of African States, there may be a threat of spreading the disease taking into account the epidemiological situation for multidrug-resistant tuberculosis and with only linezolid registered. The list of countries with a level of the same indicator above 15 per 100,000 population includes Russia and Namibia with radically different market characteristics. If Russia possesses the entire available range of medicines with the number of nomenclature items above 200, then Namibia has no more than 10 linezolid preparations registered only in tablet form. The main supplier of innovative products in the field of tuberculosis control is the Asia-Pacific region. Сonclusion. It is defined that the characteristics of the drug market differ significantly depending on the economic development of states and are determined by the indicator of the disease burden. Success in the tuberculosis control is impossible without the active development of the pharmaceutical industry and the replenishment of the market with innovative products.


2005 ◽  
Vol 16 (8) ◽  
pp. 560-570 ◽  
Author(s):  
Rifat A Atun ◽  
Reda Lebcir ◽  
Francis Drobniewski ◽  
Richard J Coker

This study sought to determine the impact of an effective programme of multidrug resistant tuberculosis control (MDRTB) on a population that is witnessing an explosive HIV epidemic among injecting drug users (IDUs), where the prevalence of MDRTB is already high. A transmission model was constructed that represents the dynamics of the drug-susceptible tuberculosis (DSTB), MDRTB and HIV spread among the adult population of Samara Oblast, Russia: from official notifications of tuberculosis and of HIV infection, estimates of MDRTB derived from surveillance studies, population data from official regional statistics, data on transmission probabilities from peer-reviewed publications and informed estimates, and policy-makers' estimates of IDU populations. Two scenarios of programme effectiveness for MDRTB were modelled and run over a period of 10 years to predict cumulative deaths. In a population of 3.3 million with a high prevalence of MDRTB, an emerging epidemic of HIV among IDUs, and a functioning directly observed therapy-short course (DOTS) programme, the model predicts that under low cure rates for MDRTB the expected cumulative deaths from tuberculosis will reach 6303 deaths including 1900 deaths from MDRTB at 10 years. Under high cure rate for MDRTB 4465 deaths will occur including 134 deaths from MDRTB. At 10 years there is little impact on HIV-infected populations from the MDRTB epidemic, but as the HIV epidemic matures the impact becomes substantial. When the model is extended to 20 years cumulative deaths from MDRTB become very high if cure rates for MDRTB are low and cumulative deaths in the HIV-infected population, likewise, are profoundly affected. In the presence of an immature HIV epidemic failure to actively control MDRTB may result in approximately a third more deaths than if effective treatment is given. As the HIV epidemic matures then the impact of MDRTB grows substantially if MDRTB control strategies are ineffective. The epidemiological starting point for these scenarios is present in many regions within the former Soviet Union and this analysis suggests control of MDRTB should be an urgent priority.


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