Untraceable, unbreakable

Missed tuberculosis cases in China and India are enabling the disease to spread, jeopardizing global efforts to slash new infections by 2015, the World Health Organization says. For every five cases diagnosed globally in 2006, four went undetected, the Geneva- based WHO says in its annual Global Tuberculosis Control report.

Progress in detection of cases slowed in that year, the most recent for which data are available, and began to stall in China and India.

Also researchers reported last week that those who carry the mutant TLR2 gene and become infected with the Beijing TB strain, prevalent in Asia and the former Soviet states, can develop potentially fatal meningitis. The Beijing family of TB strain has become more resistant to drugs in recent years.

Meanwhile, according to the Global Fund to Fight AIDS, Tuberculosis and Malaria, a third of the worlds population is infected with TB, which depletes the incomes of the worlds poorest communities by US$12 billion (HK$93.6 billion) a year.

The average rate at which new TB cases were detected fell to 3 percent a year from 2005 to 2006 from 6 percent between 2001 and 2005, according to the WHO.

You reach a certain stage where most of the cases that are easily detectable are being detected, and now it is time for countries to step up their efforts to get those cases that are more difficult to reach, says Peter van Maaren, the WHOs regional adviser on tuberculosis in the western Pacific region.

Delays in finding and treating TB may prevent the WHO from reaching its goal of cutting TB deaths by half by 2015 from 1990 levels, according to the report.

The WHO estimates 9.2 million people became infected in 2006, though only 5.1 million were diagnosed that year. Africa, Southeast Asia and the Western Pacific accounted for 83 percent of notified cases. India, China, Indonesia, South Africa and Nigeria had the most cases.

Left untreated, each person with active TB will infect between 10 and 15 people on average every year.

The diseases global spread, including to patients weakened by HIV/AIDS, is encouraging the emergence of drug- resistant strains, which now account for about 5 percent of new cases.

Drug resistance makes TB more dangerous and treatment more expensive. Drug-resistant TB, like the regular form, can be transmitted through the air to a non-infected person.

The WHO expects funding for efforts to combat TB to remain flat this year in almost all of the countries most affected by the disease.

2008-04-26

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