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Extensively drug-resistant tuberculosis (TB)

  Mar 22, 2017

Extensively drug-resistant tuberculosis (TB)

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?
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?
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?