Intended for healthcare professionals


Fighting the “white plague”

BMJ 2006; 332 doi: (Published 08 June 2006) Cite this as: BMJ 2006;332:1354
  1. Zosia Kmietowicz
  1. Tomsk

    Poverty, homelessness, alcoholism, and malnutrition produced a tuberculosis epidemic in Russia after the break up of the Soviet Union in the 1990s. In some regions, rates are now starting to fall. Zosia Kmietowicz investigates

    Jana is 19 years old, but looks closer to 12. She has just had three quarters of her right lung removed after it was almost completely destroyed by tuberculosis. Aivar Strelis, the head of tuberculosis treatment at Tomsk Hospital in Siberia, where Jana is being treated, hopes that Jana will be able to go home soon and that another 12-14 months on a combination of antibiotics will rid her of the infection in her left lung and that she will be able to pursue her ambition to study medicine.

    Embedded Image

    Men take their antituberculosis drugs at a dispensary in Tomsk

    Credit: STEVE TURNER

    Jana is among the estimated 15% of Russians who have multidrug resistant tuberculosis. They might be resistant to just one or two of the standard first line treatments, or six or even seven drugs, including those used as second line treatments.

    It is these patients who are the most difficult to treat, says Dr Strelis. They are confined to long stretches in hospital and make up the lion's share of those who need surgery (85%).

    Rates of tuberculosis in Russia are the 12th worst in …

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