Alarming concerns over the increasing cases of drug-resistant TB have come to light in recent years. Tuberculosis is a life-threatening disease that has been haunting people since the beginning of time. With rapid advancements in the medical field, this century-old disease is now curable, and patients showing symptoms of active TB cases can be treated provided they undergo proper diagnosis and healthcare. However, the breakthroughs made in Tuberculosis healthcare have suffered a major setback because of the development of drug-resistant variants.
The Global Menace of Drug-Resistant Tuberculosis
Initially, the evolution of these variants opened the gate for several research studies, but with time, they have become the major challenge faced in the upgradation of TB drugs and are rapidly affecting the improvement in the cases worldwide. The access to reports stating the testing and understanding of the drug-resistant variants remains insufficient, and the detection of these in the human body is a complex process. Amidst the increased cases with suspicion of drug-resistant TB, it has become a threat to global efforts in controlling TB cases.
Understanding Drug-Resistant Tuberculosis and Its Spectrum
It is quite clear from the term drug-resistant that Drug-resistant TB (DR TB) occurs when the bacteria become resistant to the drugs used to cure TB, and the general treatments can no longer kill the TB bacteria. DR TB is spread the same way as normal Tuberculosis through air particles, and the prevention theory is the same in both cases. The essential difference lies in the drug-resistant variations in the bacteria and the treatment process. The several types of DR TB are a cause of instability in the Tuberculosis healthcare network. These include Multidrug-Resistant TB (MDR TB), Pre-Extensively Drug-resistant TB (pre-XDR TB), and Extensively Drug-resistant TB (XDR TB).
MDR TB is caused by Tuberculosis bacteria that are resistant to isoniazid and rifampin drugs. These are the drugs used extensively in the treatment of TB, and the resistance of bacteria to these pushes the development of TB drugs to a corner.
According to an announcement by WHO, the definitions of XDR TB and pre-XDR TB were updated, and it can be concluded that XDR TB is a type of MDR TB caused by Mycobacterium tuberculosis that is resistant to any fluoroquinolone and at least one additional Group A drug, in addition to isoniazid and rifampin while pre-XDR TB is a type of MDR TB caused by bacteria that are resistant to isoniazid and rifampin and also to any fluoroquinolone.
The figures of these DR TB types underline a grave cause of concern and they ask for a dynamic change in the TB treatment regime. New drugs are required to develop new treatment regimens to treat DR TB and with studies suggesting the side effects of injectables, there is no doubt that drug-resistant TB is one of the considerable threats to global health security.
Problems Introduced by DR TB in the Global Tuberculosis Healthcare Scenario
DR TB strains are resistant to the most potent first-line drugs used for TB treatment, and hence the treatment procedure calls for a completely new strategy to counter the severe effects of the disease. Treatment of DR TB, in turn, requires more expensive and less accessible second-line drugs, which have severe side effects. According to a systematic review of the Prevalence of aminoglycoside-induced hearing loss in drug-resistant tuberculosis patients, it is revealed that in 18 studies from 10 countries, 40.6% of patients suffered persistent hearing loss after exposure to the second-line injectables.
As mentioned earlier, the treatment regime for drug-resistant TB is complex and longer, with a risk factor of treatment failure. One serious problem in the global scenario is the increased healthcare costs in the management of DR TB that place a significant financial burden on the country’s health budgets and individuals suffering from the disease. DR TB strains are transmissible just like drug-susceptible Tuberculosis, which means that individuals with DR TB can spread the resistant strains to others.
When countries are fighting to eliminate Tuberculosis, this makes it more difficult to control TB transmission and achieve global TB elimination goals. Individuals living with HIV have a higher risk of being diagnosed with DR TB due to compromised immune systems. According to 2019 WHO estimates, 8.1% of people with newly diagnosed TB had MDR-TB, and 20% of previously treated TB cases had MDR-TB among those living with HIV.
Addressing the Menace of Drug-Resistant Tuberculosis: A Multi-Faceted Approach
It is no mystery that addressing the problems introduced by DR TB requires a multi-faceted approach and collaboration between countries, and health policymakers is quintessential to tackle the global challenge of DR TB. At the individual level, there is a need to understand the risk and terms involved in the development of DR TB cases. Early detection, proper diagnosis, and timely treatment are essential to curb the spread of drug-resistant Tuberculosis.
Efforts must be intensified to develop new drugs and treatment regimens to combat DR TB effectively. Research and funding in this area need to be prioritized to find innovative solutions. Furthermore, improving healthcare infrastructure and access to quality TB treatment facilities is critical to ensuring that patients receive proper care and support throughout their treatment journey.
Battling the Scourge of Drug-Resistant Tuberculosis
Drug-resistant Tuberculosis poses a significant risk to global health security, threatening to undo the progress made in combating Tuberculosis over the years. It demands urgent attention and coordinated efforts from governments, international organizations, and healthcare professionals to implement robust strategies for prevention, detection, and treatment. By working together, we can tackle this formidable challenge and safeguard global health security for generations to come. Let us unite in the fight against drug-resistant Tuberculosis and build a healthier, safer world.