Monday 23 July 2018

Europe at risk as 'untreatable' TB cases show alarming rise

Nine of the 30 countries with the highest number of MDR-TB cases are in Europe
Nine of the 30 countries with the highest number of MDR-TB cases are in Europe

Anne Gulland in London

Europe is in the grip of an alarming rise in the number of almost untreatable cases of tuberculosis, new data has shown.

Overall, the number of cases of the airborne lung disease has fallen in recent years, but experts are becoming alarmed at how it is becoming resistant to many front-line antibiotics.

This rise in resistance is worrying, even in countries such as Ireland where infection rates are relatively low, because of the high numbers of people moving around the region.

New figures from the European Centre for Disease Prevention and Control, released in advance of World TB Day on Saturday, have shown that the number of cases of the most severe form of drug-resistant tuberculosis - known as extensively drug-resistant TB (XDR-TB) and classified as resistant to four or more drugs - has increased from around 350 in 2012 to almost 5,000 in 2016, the majority of which were in the former eastern bloc. Some 20pc of cases that were tested were shown to be XDR-TB.

But the figures also show that the number of cases of the disease that are resistant to at least two front-line treatments has also increased from 38,000 in 2012 to 51,000 in 2016.

Nine of the 30 countries with the highest number of MDR-TB (multi-drug resistant TB) cases are in Europe. The rise of drug resistance is a threat to efforts to eliminate the disease in the region, as only a third of drug-resistant cases are treatable.

Marieke van der Werf, head of TB disease at the European Centre for Disease Prevention and Control, said: "The rise in drug resistance is definitely a threat for the whole of Europe because people are mobile. You see people coming from other countries and bringing drug resistance with them. All countries need to be vigilant."

She added that part of this rise in drug resistance may be down to better detection - new rapid diagnostics were introduced across the region from 2011, and in 2016 73pc of cases of multi-drug resistant TB were detected, compared to 33pc in 2011.

She added that new treatments for TB were desperately needed. "For MDR-TB and XDR-TB the treatment takes 18 to 24 months and sometimes even longer if we don't get it under control. Patients have to take a serious number of drugs with serious side-effects that can be really horrible. They tell us it's a struggle to stick to the regime," said Dr Van der Werf.

The new figures also show there were 290,000 cases of TB across Europe in 2016, compared to 366,000 in 2012. While this fall is welcome, the rate of decline is too slow if the region is to wipe out the disease by 2030, as governments around the world have committed to.

Zsuzsanna Jakab, World Health Organisation regional director for Europe, said the region needed to "leap forward".

She said: "We need to revamp political commitment at all levels to achieve tangible and immediate results that change and save the lives of all those people suffering from TB today and ensure a TB-free world for our children tomorrow."

Irish Independent

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