Wins, Losses Cited in Fight to Control TB In 2005, 8.8 million people worldwide were infected with tuberculosis, a slight increase over the previous year. Many countries have improved treatment, but some parts of the world, especially sub-Saharan Africa, remain vulnerable. And a new strain of TB is troublesome.
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Wins, Losses Cited in Fight to Control TB

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Wins, Losses Cited in Fight to Control TB

Wins, Losses Cited in Fight to Control TB

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Here's a staggering number. In 2005, 8.8 million people around the world became infected with tuberculosis. In fact, that represents a leveling off of the global TB epidemic, but now health experts are worried about a frightening new problem, a form of tuberculosis that's even deadlier and harder to treat.

NPR's Brenda Wilson reports.

BRENDA WILSON: New cases of tuberculosis went up by about 70,000 in 2005, a slight increase in the millions of people around the world who become infected each year. Mario Raviglione, coordinator of tuberculosis programs for the World Health Organization, says that's actually not as high as the previous year.

Mr. MARIO RAVIGLIONE (Coordinator, WHO Stop Tuberculosis Program): It means that the population of the world is growing faster now than TB. That explains why you have slightly more cases in total number, but in relation to the population there has been a peak.

WILSON: And part of the reason it's stabilizing is that some countries are becoming more effective in detecting cases of the disease and making sure that the patient is cured. Curing patients helps control the disease. More than 26 million were cured of TB in 2005, especially in Asia.

Mr. RAVIGLIONE: If you take China, India, Indonesia, Philippines, Cambodia, Vietnam, these are all countries that have put together effective programs that are reaching today quite a high case of detection. So they detect many cases in their own population and they cure the large majority of them, which is really an advance compared to, say, five or 10 years ago.

WILSON: The situation is much worse in Africa, if not in size then in intensity. Twelve out of the 15 countries with the highest rate of TB are in Africa, where the epidemic of AIDS increases people's vulnerability to the disease and undercuts the ability of health systems to respond.

Paul Nunn is WHO's director of Stop TB.

Dr. PAUL NUNN (Director, WHO's Stop TB Program): You've got to make sure that every patient receives a full course of treatment right to the very end and takes all the pills in the process. If that is not happening, then you're letting the patient down and putting the community at risk.

WILSON: And TB patients are seldom checked to see if they also have HIV. In not-so-poor South Africa, which has access to a second line of TB drugs when treatment fails, that led to an outbreak of what is being called extensively drug resistant or XDR-TB, where the first and second line drugs didn't work. Nearly all of those initially identified with the disease, 52 out of 53 died.

Dr. NUNN: Not only is the problem really severe, but in the area where it's flashed up in a high HIV-prevalent setting, it is still not under control.

WILSON: More cases are being identified, but mortality rates are down. Nunn says countries poorer than South Africa wouldn't be able to handle such an outbreak.

Dr. NUNN: There's a real risk that if it starts to travel to the north of South Africa, it will go into countries where the laboratory capacity even to recognize that it's there doesn't exist.

WILSON: XDR is spreading in other parts of the world too, to 35 countries including the U.S. In the U.S., in the last five years, 17 cases of XDR have been identified.

Kenneth Castro, the director of the Center for Disease Control and Prevention Division of Tuberculosis Elimination, says the majority of those cases were in people born outside of the U.S.

Dr. KENNETH CASTRO (Director, Center for Disease Control and Prevention Division of Tuberculosis Elimination): We need to make sure that we help reduce the number of persons with tuberculosis and by doing so reduce the likelihood of importation, as well as the likelihood of us becoming infected as we travel and live overseas.

WILSON: And he says that's one reason we need to keep investing in controlling TB in other countries.

Brenda Wilson, NPR News.

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