Drug-resistant tuberculosis

Abstract

Tuberculosis, an airborne infectious disease caused by the organism Mycobacterium tuberculosis, has been a leading cause of death for centuries and remains a major cause of morbidity and mortality in many parts of the world. In 2012, 8.6 million people became sick with tuberculosis, and 1.3 million died from this curable disease (World Health Organization 2013a). While the majority of cases are caused by strains susceptible to all antituberculosis antibiotics, drug resistance is a major concern that carries the potential to reverse decades of progress in tuberculosis control. This chapter examines the global epidemiology of drug-resistant tuberculosis and the drivers for development of drug resistance and its spread within populations. We explore the reasons for the complex nexus between drug resistance and access to health care, including case studies of countries whose epidemics have taken different trajectories. We examine the important implications of drug-resistant tuberculosis for health systems in both the developed world and low- and middleincome countries. Finally, we discuss the elements needed to control the spread of drug-resistant tuberculosis.