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Drug-resistant TB on increase in UK

02/05/2008

Drug-resistant tuberculosis (TB) is increasing in the UK, health experts have warned today.

A report in the British Medical Journal (BMJ) says the rise is due to a changing population structure and ongoing migration.

About nine million new cases of TB, an infectious disease caused by bacteria, emerge globally each year, resulting in nearly two million deaths.

It is spread by close, prolonged personal contact to somebody with infectious TB.

While anti-tuberculosis drug resistance is increasing globally, resistance to anti-tuberculosis drugs in the UK remained stable between 1993 and 1998.

But the BMJ report says from 1998 to 2005 the proportion of cases resistant to any first line anti-tuberculosis drug increased from 5.6 per cent to 7.9 per cent.

There was an increasing proportion of isoniazid resistance (6.9 per cent) and small increases in rifampicin resistance (1.2 per cent) and multi-drug resistance (0.9 per cent).

Researchers from the Health Protection Agency, University of East Anglia and the Mycobacterium Reference Unit uncovered the rise after studying data from the National Surveillance System, involving 28,620 confirmed cases of tuberculosis.

They discovered that there was a significant increase in resistance to the drug isoniazid outside of London, which the researchers say is associated with increasing numbers of cases from sub-Saharan Africa and the Indian subcontinent.

In London, the rise in isoniazid resistance is linked to an ongoing outbreak from 1999 that has involved over 300 cases to date.

The report says there has been "inadequate control" of TB transmission in London.

A number of measures are recommended by the researchers to halt the spread of drug-resistant tuberculosis.

"Increased awareness, early case detection, rapid drug susceptibility testing, completion of treatment, continuous surveillance, and a contribution to control of tuberculosis in high incidence countries are needed to halt the observed trends," they conclude.