Tuberculosis kills more than 1.7 million people around the world each year, and this figure is growing as over-crowded conditions in poverty stricken areas can elevate transmission rates. The World Health Organization’s (WHO) recently published report, entitled “Multidrug and extensively drug-resistant TB (M/XDR-TB): 2010 Global Report on Surveillance and Response” outlines the prevalence of the disease and its potential global impact. In it, data from 114 countries around the world are examined to determine the extent of this “serious threat to global health.”
Mycobacterium tuberculosis, the organism that causes tuberculosis (TB), is an airborne bacteria exclusive to humans and can be transmitted through close personal contact, particularly coughing. According to the United States Centers for Disease Control and Prevention (CDC), the bacteria usually affect the lungs of an individual, but can also impact the kidneys, spine and brain. Nikoloz Sadradze, International Committee of the Red Cross (ICRC) medical delegate, explains that more than two billion people – approximately one in three – carry the microbes that cause TB, but only one in ten will actually experience symptoms. Effective treatment of TB depends on daily doses of courses of medication lasting six to eight months. Tuberculosis infection is defined as multidrug-resistant (MDR-TB) if it cannot be eradicated by the antibiotics commonly used to treat tuberculosis: isoniazid and rifampicin. It is classed as extensively drug-resistant (XDR-TB) if it is also resistant to fluoroquinolone antibiotics and the injectable drugs amikacin, kanamycin, and capreomycin. If an individual contracts a MDR-TB or XDR-TB strain, a combination of oral medications, injections, and other treatment may be required for 24 to 36 months or longer. Costs associated with treating MDR-TB are, on average, 10 times more than “standard” TB. The WHO reports that 60 percent of individuals who contract of TB have been cured.
The WHO also reports that drug-resistant forms of TB killed approximately 150,000 people in 2008, and that 50 percent of all cases of MDR and XDR-TB occurred in India and China. Further, 57 countries have had at least one case of XDR-TB since September 2009, according the WHO report. Programs to combat the spread of tuberculosis have been established by the WHO in 30 countries around the world, primarily those that are impacted most by the disease. Reports from the CDC indicate that reported TB cases in the United States are at an all time low, but that there were a total of 108 reported cases of MDR-TB in the U.S. in 2008. According to the WHO there were approximately 440,000 reported cases of MDR-TB worldwide in 2008. Many cases of MDR and XDR-TB are due to individuals lacking access to necessary medical attention and drug treatments. In addition to a lack of available treatment, reports indicate that only an estimated seven percent of patients with MDR-TB are diagnosed.
In regions where access to medical care and treatment may be limited, telemedicine can be used to improve the rate of diagnosis and treatment outcomes. Programs like iCons in Medicine allow healthcare providers in remote and medically underserved areas to connect with physicians who can provide knowledge and guidance for recognizing and treating tuberculosis.