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BMJ 2008;336:1201-1202 (31 May), doi:10.1136/bmj.39560.630613.80 (published 1 May 2008)
Control depends on a global perspective, not solely on local strategies
| The first 150 words of the full text of this article appear below. |
Tuberculosis has resurged in the United Kingdom over the past two decades, with 8000 cases being reported in 2006.1 Previous reports have indicated a stable proportion of drug resistance in people with tuberculosis in the UK from 1993 to 1999.2 In the accompanying paper, Kruijshaar and colleagues present an updated analysis of trends in drug resistance in tuberculosis cases in the UK.3
Kruijshaar and colleagues report an increasing proportion of isoniazid resistance (from 5% to 6.9%) and modest increases in the proportions of rifampicin resistance (1.0% to 1.2%) and multidrug resistance (0.8% to 0.9%).3 However, the true burden of drug resistant tuberculosis is better shown by the incidence of resistant cases, rather than the proportion of cases that are resistant.4 Although the increase in the proportion of resistant cases is modest, when combined with the rising incidence, the increase in numbers of resistant cases is greater than would be assumed
James J C Lewis, lecturer1, Violet N Chihota, research scientist2
1 London School of Hygiene and Tropical Medicine, London WC1E 7HT, 2 Aurum Institute for Health Research, Johannesburg, South Africa
james.lewis@lshtm.ac.uk
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