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Additional info for Addressing the Threat of Drug-Resistant Tuberculosis: A Realistic Assessment of the Challenge: Workshop Summary
Current drug resistance surveys include only smear-positive TB cases, yet not all MDR TB cases are smear positive. In Latvia and the Ukraine, for example, where MDR TB rates are segregated on the basis of HIV status, it has been shown that there is a significant association between HIV positivity and MDR TB. Furthermore, HIV-positive TB patients are more likely than other TB patients to be smear negative. Given the high prevalence of HIV in many parts of Africa, current drug resistance protocols may substantially underestimate MDR TB levels.
39 MDR TB TRANSMISSION Tugela Ferry June 2005 Tugela Ferry Tugela Ferry June 2006 March 2007 FIGURE 3-2 Facilities in KwaZulu-Natal Province where at least one XDR TB case was described or diagnosed from June 2005 to March 2007. new as Consider NOTE: There were 6 such3-2 facilities of Junebroadside 2005, a figure that had increased to 32 by June 2006 and 42 by March 2007. More than 60 facilities in KwaZulu-Natal have now reported cases of XDR TB. , 2007. , 2007). This situation is not limited to Tugela Ferry or to KwaZulu-Natal Province.
Unknown ???????????????????????? Patients seen and not diagnosed Patients not seen or diagnosed FIGURE 2-7 A representation of the limited knowledge of the extent of MDR TB in KwaZulu-Natal Province, 2006. NOTE: KGV = King George V Hospital. SOURCE: Friedland, 2008. Figure 2-7 R01436 Impact of MDR and XDR TB on Mortality fully editable Very high mortality is associated with the cases of MDR and XDR TB in Tugela Ferry. , 2009). Figure 2-8 shows the differences in mortality between MDR and XDR TB for Tugela Ferry; the top curve represents MDR TB mortality and the bottom curve XDR TB mortality.
Addressing the Threat of Drug-Resistant Tuberculosis: A Realistic Assessment of the Challenge: Workshop Summary by Institute of Medicine