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Abstract
Available data show that Africa, together with the Americas and western and central
Europe, reported the lowest prevalence of multidrug-resistant tuberculosis (MDR-TB).
However, sub-Saharan Africa has a high TB incidence and the highest human immunodeficiency
virus (HIV) prevalence in the world, and because of the high number of TB cases, Africa
still presents 14% of the global burden of new MDR-TB cases. Until recently, Africa
and South America were deprived of second-line antituberculosis drugs, preventing
the development of extensively drug-resistant TB (XDR-TB). Current efforts, introducing
improved laboratory infrastructure and second-line TB treatment in resource-limited
countries, need to be carried out with care to minimize the development of MDR/XDR-TB
in these countries. Recent diagnostic developments now need evaluation and implementation
in resource-limited areas, and delays in diagnosis also need to be addressed. Outcomes
for MDR/XDR-TB have improved, but prevention of MDR/XDR-TB by early diagnosis and
treatment, improvement of adherence, and proper infection control remains the mainstay
for the future.