Multidrug-Resistant Tuberculosis On The Rise In Victoria, Australia

Main Category: Tuberculosis
Article Date: 21 Sep 2009 - 3:00 PDT

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Cases of multidrug-resistant tuberculosis (MDR-TB) in Victoria rose between 1998 and 2007, data published in the Medical Journal of Australia has revealed.

A review of Victorian Department of Health data showed 31 people who resided in Victoria were diagnosed with MDR-TB.

The annual number of new MDR-TB cases increased during the period, and the highest number of cases diagnosed in any year was seven (in 2004, 2006 and 2007).

The study's authors, from the Victorian Infectious Diseases Reference Laboratory, Department of Health and Austin Health, said if the increase was sustained, there would be significant implications for public health policy and planning.

"The management of MDR-TB involves the use of complex second- and third-line anti-TB drug regimens and, compared with drug-susceptible TB, prolonged periods of hospitalisation in negative-pressure rooms with specialist nursing care, multidisciplinary medical input and extensive use of laboratory services," the study's lead author Ms Caroline Lavender said.

MDR-TB is resistant to isoniazid and rifampicin - two of the most effective anti-TB antibiotics. It is initially caused by improper use of these antibiotics during the treatment of patients with drug-susceptible TB.

Ms Lavender said 29 of the 31 patients were born overseas, and almost two thirds of these were from India, Vietnam or China. She said new TB control strategies should be considered in Australia, including increased use of molecular tests for the rapid detection of drug resistance.

"Another measure that might prove useful is providing information to people at high risk of TB on arrival in Australia, so they know to seek medical attention early should they develop a persistent cough or other symptoms suggestive of TB," Ms Lavender said.

The Medical Journal of Australia is a publication of the Australian Medical Association.

Source
Australian Medical Association