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  1. 1
    316980

    Drug resistance in tuberculosis [editorial]

    Ebrahim GJ

    Journal of Tropical Pediatrics. 2007 Jun; 53(3):147-149.

    Tuberculosis (TB) kills about 2 million adults and around 100 000 children every year. One-third of the world's population are currently infected with Mycobacterium tuberculosis and many have active disease. In Europe TB emerged as a major disease in the latter part of the 14th century. The industrial revolution saw rapid growth of urban centres where overcrowding with poor living conditions provided ideal circumstances for the spread of the disease. Great impact was made by streptomycin and isoniazid, so that by the 1970s TB was no longer being considered a problem in the developed world. But beginning in the 1980s the number of new cases of TB in USA and across Europe rose sharply. The pattern was repeated in many countries and worldwide throughout the 1990s and into the new millennium. The incidence of TB climbed to over 9 million cases every year. In 1993 the World Health Organization (WHO) declared TB as a global emergency. During the 1990s multidrug resistant tuberculosis (MDR-TB), defined as resistance to at least isoniazid and rifampicin, emerged as a threat to TB control. MDR-TB requires the use of second line drugs that are less effective, more toxic and costlier. In a global survey of 17 690 TB isolates during 2000-04, 20% were MDR and 2% were extremely drug resistant (XDR). XDR-TB is defined as MDR plus resistance to any fluoroquinolones and at least one of three injectable second line drugs kanamycin and amikacin, or capreomycin or both. Currently one in ten new infections is resistant to at least one antituberculosis drug. (excerpt)
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  2. 2
    310512

    Intersecting epidemics: tuberculosis and HIV.

    Worley H

    Washington, D.C., Population Reference Bureau [PRB], 2006 Apr. 5 p.

    As if the global AIDS pandemic alone were not enough, developing countries are beset with converging epidemics of HIV and tuberculosis (TB)--increasing the likelihood of premature death in these countries. Worldwide, 14 million people are coinfected with TB and HIV--70 percent of those in sub-Saharan Africa (see figure for five countries with particularly high coinfection rates). TB is the leading cause of death for those infected with HIV and is implicated in up to one-half of all AIDS deaths. And because HIV compromises the immune system, HIV-positive people are 50 times more likely to develop active TB than those who are HIV-negative. (excerpt)
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