Role of person-to-person spread in drug-resistant TB epidemic

South Africa is experiencing a widespread epidemic of drug-resistant tuberculosis (XDR TB), the deadliest form of TB. Person-to-person transmission, not just inadequate treatment, is driving the spread of the disease, according to a study published in The New England Journal of Medicine and written by Neel Gandhi, associate professor of epidemiology and global health.

The study identified numerous opportunities for transmission not only in hospitals, but also in community settings, such as households and workplaces. This has important implications for efforts to prevent the disease, which have traditionally focused on ensuring that patients receive accurate and complete TB treatment.

"These findings provide insight as to why this epidemic continues despite interventions to improve TB treatment over the past decade. Public health and research efforts must focus more intensely on identifying and implementing additional or new interventions that halt transmission," says Gandhi.

Drug-resistant TB is a significant global epidemic. Reported in 105 countries, XDR TB is resistant to at least four of the key anti-TB drugs. In most settings, treatment is effective less than 40 percent of the time, with death rates as high as 80 percent for patients who also have HIV.

Related Story

"Study highlights role of person-to-person spread in drug-resistant TB epidemics" (1/27/2017)