September 22, 2009
New research shows cases of multidrug-resistant tuberculosis (MDR TB) are increasing in Victoria, a trend with "significant implications for public health policy and planning," according to the study's investigators.
Caroline Lavender of the Victorian Infectious Diseases Reference Laboratory and colleagues reviewed provincial health department data from 1998 to 2007 and found 31 MDR TB cases were diagnosed during that timeframe. Most of the reports occurred in the final few years of the 10-year review, with seven cases per year in 2004, 2006, and 2007. Furthermore, "New data available since the completion of our study reveal that the increase appears to have been sustained in 2008," the team said.
Most of the MDR TB cases (29 of 31) occurred among people born overseas, and nearly two-thirds were from China, India or Vietnam. MDR TB incidence has increased five-fold as a proportion of all TB notifications in Victoria. "Our study revealed that there was a clear increase in the number of patients diagnosed with MDR-TB," said Lavender. MDR-TB is resistant to isoniazid and rifampicin; it results from the improper use of these antibiotics during treatment for non-drug-resistant TB. Australia should consider new TB control strategies, including the use of molecular tests for the rapid detection of drug resistance, the team urged. "Another measure that might prove useful is providing information to people at high risk of TB on arrival to Australia, so they know to seek medical attention early should they develop a persistent cough or other symptoms suggesting of TB," said Lavender.
The report, "Multidrug-Resistant Tuberculosis in Victoria: a 10-Year Review," was published in the Medical Journal of Australia (2009;191(6):315-318).