The Global Project on Anti-Tuberculosis Drug Resistance has been gathering data since
1994. This study provides the latest data on the extent of drug resistance worldwide.
Data for drug susceptibility were gathered from 90 726 patients in 83 countries and
territories between 2002 and 2007. Standardised collection of results enabled comparison
both between and within countries. Where possible, data for HIV status and resistance
to second-line drugs were also obtained. Laboratory data were quality assured by the
Supranational Tuberculosis Reference Laboratory Network.
The median prevalence of resistance to any drug in new cases of tuberculosis was 11.1%
(IQR 7.0-22.3). The prevalence of multidrug resistance in new tuberculosis cases ranged
from 0% in eight countries to 7% in two provinces in China, 11.1% in Northern Mariana
Islands (although reporting only two cases), and between 6.8% and 22.3% in nine countries
of the former Soviet Union, including 19.4% in Moldova and 22.3% in Baku, Azerbaijan
(median for countries surveyed 1.6%, IQR 0.6-3.9). Trend analysis showed that between
1994 and 2007, the prevalence of multidrug-resistant (MDR) tuberculosis in new cases
increased substantially in South Korea and in Tomsk Oblast and Orel Oblast, Russia,
but was stable in Estonia and Latvia. The prevalence of MDR tuberculosis in all tuberculosis
cases decreased in Hong Kong and the USA. 37 countries and territories reported representative
data on extensively drug-resistant (XDR) tuberculosis. Five countries, all from the
former Soviet Union, reported 25 cases or more of XDR tuberculosis each, with prevalence
among MDR-tuberculosis cases ranging between 6.6% and 23.7%.
MDR tuberculosis remains a threat to tuberculosis control in provinces in China and
countries of the former Soviet Union. Data on drug resistance are unavailable in many
countries, especially in Africa, emphasising the need to develop easier methods for
surveillance of resistance in tuberculosis.
Global Project: United States Agency for International Development and Eli Lilly and
Company. Drug resistance surveys: national tuberculosis programmes, the Government
of the Netherlands, the Global Fund to Fight AIDS, Tuberculosis and Malaria, Japan
International Cooperation Agency, and Kreditanstalt für Wiederaufbau.