Global Incidence of Multidrug‐Resistant Tuberculosis

TLDR

Global MDR‑TB incidence was estimated at 272,906 cases in 2000, and updated models incorporating additional countries and previously treated cases are needed for effective TB control planning. The study aims to highlight the urgent need to expand diagnostic and treatment services for MDR‑TB in low‑resource settings based on updated burden estimates. The authors used multiple logistic regression on data from 90 new‑case and 77 previously treated‑case surveys to identify predictors of MDR‑TB frequency and applied the model to estimate frequencies in unsurveyed countries. In 2004, an estimated 424,203 MDR‑TB cases (4.3% of all TB cases) were reported worldwide, with 181,408 among previously treated cases and 261,362 (62%) occurring in China, India, and Russia.

Abstract

The global number of incident cases of multidrug-resistant (MDR) tuberculosis (TB) in 2000 was estimated to be 272,906 (95% confidence interval [CI], 184,948-414,295). For accurate planning of TB control programs, this estimate and others have been revised using data from additional countries and by including in the model previously treated TB cases, which had not been accounted for in the previous analysis.Multiple logistic regression was used to identify variables that were predictive of MDR-TB frequency among new and previously treated cases surveyed in 90 and 77 countries, respectively. These variables were then used to estimate MDR-TB frequencies in countries that had not been surveyed.The total number of MDR-TB cases estimated to have occurred worldwide in 2004 is 424,203 (95% CI, 376,019-620,061), or 4.3% (95% CI, 3.8%-6.1%) of all new and previously treated TB cases. In the same year, 181,408 (95% CI, 135,276-319,017) MDR-TB cases were estimated to have occurred among previously treated TB cases alone. Three countries--China, India, and the Russian Federation--accounted for 261,362 (95% CI, 180,779-414,749) MDR-TB cases, or 62% of the estimated global burden.These updated sets of estimates incorporating previously treated TB cases call for an urgent plan to expand appropriate diagnostic and treatment services for patients with MDR-TB in low-resource settings.