Review: multidrug-resistant tuberculosis: public health challenges.

Abstract

Recently the traditional terms ‘acquired drug resistance’ and ‘primary drug resistance’ have been superseded by the terms ‘drug resistance among new cases’ as a proxy of primary resistance and ‘drug resistance among previously treated cases’ as a proxy of acquired resistance. The reason for this is that patients may not disclose prior treatment for tuberculosis (which would have led to the term ‘primary drug resistance’ being erroneously used). Alternatively patients may fail treatment because their strain was resistant from the start and not because it acquired resistance as a consequence of treatment (which would have led to the term ‘acquired drug resistance’ being applied inappropriately). The purpose of this paper is to describe some of the public health challenges many of which are formidable facing those involved in countering the threat posed by MDRTB (multi-drug-resistant tuberculosis). (excerpt)