Strategies against multidrug-resistant tuberculosis

Abstract

The rise of multidrug-resistant tuberculosis (MDR-TB), defined as tuberculosis showing resistance to at least isoniazid and rifampicin, is a serious threat to tuberculosis control in some high prevalence countries and may have some impact on low prevalence regions as well.The World Health Organization estimates that 50 million people worldwide are infected with MDR-TB, and that, in the year 2000, 273,000 (3.1%) MDR-TB cases were among the 8.7 million new tuberculosis cases. In 1998, the highest MDR-TB rates among new cases and the highest combined (new and previously treated cases) MDR-TB rates were found in Estonia (14.1 and 18.1%), Henan province in China (10.8 and 15.1%), Latvia (9.0 and 12.0%), and Ivanovo Oblast (9.0 and 12.3%) and Tomsk Oblast (6.5 and 13.7%) in the Russian Federation. The risk factors for MDR-TB are previous treatment or relapse, originating from “hot spot” areas, a history of imprisonment, homelessness and possibly also human immunodeficiency virus.The treatment of multidrug-resistant tuberculosis is difficult due to side-effects and a treatment duration of up to 3 yrs, which is expensive and often unsuccessful. Therefore, strategies for the treatment and prevention of multidrug-resistant tuberculosis are urgently required. This requires functioning tuberculosis control programmes (directly observed treatment short course), and, in some high prevalence countries, the introduction of second-line drugs on the basis of appropriate susceptibility testing (directly observed treatment short course-Plus). Only the future will show whether this “ticking time bomb” can be defused.

Molecular genotyping and epidemiology of Mycobacterium tuberculosis isolates obtained from inmates of correctional institutions of Campinas, Southeast Brazil

“…Patients with MDR strains do not respond to treatment with commonly used drugs [7,28,[34][35][36] and their treatment is long and expensive. Among the MDR screening features is the interruption of treatment and indiscriminate use of chemotherapy [7,28].…”

Recent Efforts for the Development of Antitubercular Drug Containing Diazine Ring

“…Compounds 2a-h and 3a-h 1a-1d R 1 =H, 1e-1h R 1 =F, 1i-1l R 1 =Cl 2a-2h R=p-Cl, 3a-3h R=p-CH 3 ; 2a and 3a R'=H; 1a, 1e and 1i R 2 =H; 1b, 1f, and 1j R 2 =Br 2b and 3b R'=p-Cl; 2c and 3c R'=p-NO 2 ; 2d and 3d R'=p-OH; 1c, 1g and 1k R 2 =Cl; 1d, 1h and 1l R 2 =F 2e and 3e R'=p-CH 3 ; 2f and 3f R'=p-OCH 3 , 2g and 3g R'=p-OH, m-OCH 3 ; 2h and 3h R'=p-F Two series of pyridazinone derivatives (19)(20)(21)(22)(23)(24)(25)(26)(27)(28)(29)(30)(31)(32)(33)(34) were evaluated for anti-TB activities against Mtb H37Rv strain. The compound 2g, 5-(4-hydroxy-3-methoxybenzyl)-3-(4-chloro-phenyl)-1,6-dihydro-6-pyridazinone emerged as a lead compound with good anti-TB activity.…”

“…The occurrence of this disease is linked to dense population, poor nutrition, and poor sanitation. Observed Treatment, short-course (DOTS) strategy, constitutes the cornerstone of the current protocol for control of TB [18][19][20][21][22][23][24][25]. Despite the success of DOTS strategy, the emergence of MDR-TB strains, recurrently isolated from patient's sputum, darken the future.…”

Influence of Family System Characteristics on Adherence to Directly Observed Treatment, Short-Course (Dots) in Pulmonary Tuberculosis-A Cohort Study

“…The Tb is associated with poverty, 95% of cases and 98% of deaths occur in developing countries, most of these deaths occur in young people [1,2]. It is estimated that in 2008 there were 9.4 million new cases of TB, which killed 1.8 million people [3].…”