Multidrug-Resistant Tuberculosis (MDR-TB)

Multi Drug Resistant Tuberculosis – Bacteria Resist Treatment

Multi drug resistant tuberculosis –MDR-TB could be defined as a type of TB infection that is caused by bacteria which tend to resist to treatment with at least two of the most powerful first line treatment anti TB drugs. MDR-TB has appeared due to the insufficiency of treatment. Presently, treatment for drug resistant TB takes up to two years and is quite complex, expensive and toxic with most of the people unable to get the treatment. Those who get it, more than a third tend to die.

Anti-tuberculosis drug resistance is a main public health issue threatening the progress made in TB treatment and control around the world. In 2013, around 5% of the TB cases around the world were estimated to be MDR-TB cases including 3.5% of newly diagnosed cases of TB with 20.5% previously treated TB cases. While the rates of the infections of MDR-TB cases are quite low in North America and Western Europe, they are a cause of serious problem worldwide in specific areas of Russian Federation, the former Soviet Union as well as other areas of Asia.

It could be classified as primary or acquired. Primary MDR-TB takes place in persons who have not been previously infected with TB but could get infected with a strain that is resistant to treatment while Acquired MDR-TB occurs during treatment with a drug regiment which is not effective in killing the particular strain of TB that they have been infected.

Inadequate Treatment – Single Anti TB Drug

Several of the cases of acquired MDR-TB are the result of inadequate treatment with single anti TB drug usually INH which could take place due to medical provider, in prescribing the ineffective treatment though it could also be due to taking the medication incorrectly by the patient.

 This could be due to various reasons comprising of expenses or scarcity of medicines, forgetfulness in the patients, or even stopping the treatment early when they tend to feel better. Care of MDR-TB needs treatment with second line drugs which are generally four or more anti-TB drugs for 6 months minimum, extending for 18 – 24 months if the resistance has been observed in a certain strain of TB in the person who is infected. Second-line drugs usually are less effective, more toxic and quite expensive than first line drugs and under ideal program circumstances, MDR-TB cure rate is around 70%

WHO – Developed Guidelines & Stop TB Strategy

Multidrug resistant tuberculosis is difficult in treating and there could be a shortage of information with regards to this infectious disease. World Health Organization – WHO has developed guidelines and the Stop TB Strategy for preventing, controlling as well as treatmentof MDR-TB, by utilising accessible data all over the world. However, the guidelines are theoretical knowledge which cannot be transferred into actual practice and the WMA hence volunteered to develop a learning program for the MDR-TB guidelines.

In 2010, the course was updated together with the new WHO MDR-TB strategy. The online course for MDR-TB is available as a free self-learning online tool in English and Mandarin Chinese enabling physicians all across the world to learn and test their knowledge about MDR-TB and is accredited by the South African Medical Association and the Norwegian Medical Association and hence will be recognized all over Europe.