Multidrug resistant tuberculosis (MDR-TB) in emerging economies in Sub-Saharan Africa: clinicians’ public health concerns

Abstract

Despite improvement in the control of Tuberculosis globally, the disease remains a major public health problem responsible for high morbidity and mortality. In 2013 alone an estimated 9 million people acquired Tuberculosis, while mortality was at 1.5 million people that year. The emergence of multidrug resistant tuberculosis (MDR-TB) is tending to reverse earlier gains in the Tuberculosis control efforts, especially in resources limited settings in Sub Saharan Africa (SSA). The largest negative impact is expected in high-risk populations in whom the prevalence of pulmonary TB is already high. The challenges in these settings are numerous and are important for the epidemiology of MDR-TB. Alliances of negative forces and social determinants of health such as poverty, low levels of literacy, gender inequality and poorly resourced health systems may play a big role in the spread of MDR-TB. Furthermore, high cost of treatment and lack of health workers are hindrances to proper control of TB. HIV infection and male gender have been cited to be risk factors. Efforts to control this epidemic require control of HIV and more male involvement in the most affected regions. In our perspective we discuss epidemiology of MRD-TB in SSA.