What is XDR-TB?
XDR-TB, an abbreviation for extensively drug-resistant tuberculosis (TB), is a form of TB which is resistant to at least four of the core anti-TB drugs.
Multidrug-resistance (MDR-TB) and XDR-TB both take substantially longer to treat than ordinary (drug-susceptible) TB, and require the use of second-line anti-TB drugs, which are more expensive and have more side-effects than the first-line drugs used for drug-susceptible TB.
How do people get XDR-TB?
People may get XDR-TB in one of two ways.
How easily is XDR-TB spread?
- It may develop in a patient who is receiving treatment for active TB, when anti-TB drugs are misused or mismanaged, and is usually a sign of inadequate clinical care or drug management.
- People can develop XDR-TB by becoming infected from a patient who is already ill with the condition. Patients with TB of the lungs can spread the disease by coughing, sneezing, or simply talking.
People in any one place together, and the presence of people with a higher risk of being infected (such as those with HIV/AIDS).
How can a person avoid becoming infected with XDR-TB?
How can a person who already has ordinary TB avoid getting XDR-TB?
- While patients with XDR-TB may be as infectious as those with ordinary TB, the chances of a TB infection being XDR-TB is lower due to the rarity of the condition.
- Close contact with a patient with infectious TB is to be avoided especially in poorly ventilated spaces. The risk of becoming infected with TB is very low outdoors in the open air.
No doses should be missed and above all, treatment should be taken right through to the end.
Can XDR-TB be cured or treated?
XDR-TB patients can be cured, but with the current drugs available, the likelihood of success is much smaller than in patients with ordinary TB or even MDR-TB. Cure depends on the extent of the drug resistance, the severity of the disease and whether the patient’s immune system is compromised.
How common is XDR-TB?
XDR-TB is rare; however, 117 countries worldwide had reported at least one case by the end of 2015.
How do countries prevent XDR-TB?
National TB control programmes working with all health services can prevent XDR-TB by ensuring that all practitioners working with people with TB adhere to the International Standards for TB Care.
These emphasize providing proper diagnosis and treatment to all TB patients, including those with drug-resistant TB; assuring regular, timely supplies of all anti-TB drugs; proper management of anti-TB drugs and providing support to patients to maximize adherence to prescribed regimens; caring for MDR/XDR-TB cases in services with proper ventilation, and minimizing contact with other patients, particularly those with HIV, especially in the early stages before treatment has had a chance to reduce the infectiousness.
Can the TB vaccine, known as BCG, prevent XDR-TB?
The BCG vaccine prevents severe forms of TB in children, such as TB meningitis, but is less effective in preventing pulmonary TB in adults. It is expected that the effectiveness of BCG against XDR-TB is similar as for ordinary TB.
What are the symptoms TB or XDR-TB?
Symptoms of XDR-TB are no different from ordinary TB: a cough with thick, cloudy mucus (or sputum), sometimes with blood, for more than 2 weeks; fever, chills, and night sweats; fatigue and muscle weakness; weight loss; and in some cases shortness of breath and chest pain.
What is WHO doing to combat XDR-TB?
- Firstly, WHO is ensuring that the health authorities responsible for TB care and control receive accurate information about XDR-TB. Latest information on XDR-TB, and related TB issues, are published on the WHO Global TB Programme website.
- Secondly, WHO advises that good TB prevention, care and control prevents the emergence of drug resistance in the first place, and that the proper treatment of MDR-TB prevents the emergence of XDR-TB.
- Thirdly, WHO is regularly updating its guidance to Ministries of Health on the management of drug-resistant TB patients and diagnostic policies.