Despite Progress, Tuberculosis Still Menace In Parts Of World Upheaval In Eastern Europe, Russia Leads To Resurgence Of Tb

Better treatment has stabilized the spread of tuberculosis worldwide for the first time in decades, but U.N. health officials said Wednesday that a growing TB epidemic in Russia is threatening Europe.

The global TB epidemic has leveled off because health care workers are being trained to make sure patients take the full, six-month course of medication, World Health Organization officials said at a news conference.

They said widespread use of the new “DOTS” or Directly Observed Treatment, Short-course - method could cut the number of TB cases in half over the next decade, saving 10 million lives, as well as prevent the development of drugresistant strains.

But the method is still not being used in Eastern Europe, and economic and social upheaval in Russia and other former Soviet bloc countries since the end of communism has contributed to a tuberculosis explosion there.

Since 1991, Russia has seen a 70 percent rise in TB cases and a 90 percent jump in TB death rates, said Richard Bumgarner, deputy director of the WHO’s Global TB Program.

Lethal drug-resistant strains account for 6 percent of the TB cases in the Baltic country of Latvia, 14 percent in Estonia and 18 percent in Lithuania, he said.

“Make no mistake,” Bumgarner said. “Europe has been heading slowly but surely to another TB crisis.”

Tuberculosis, the world’s top infectious killer, is spread through coughing and sneezing and can be highly contagious.

Although effective and affordable drugs have been available since the 1950s, they generally must be taken for six to eight months. Many patients, especially in poorer countries, stop taking them as soon as they begin to feel better because of the inconvenience or to save money.

That allows the stronger TB germs that resisted the initial drug onslaught to reproduce, making it harder, if not impossible, to cure later.

Fully adopted in the United States and elsewhere since the early 1990s, the DOTS method involves better identification of cases and training of people to administer medication.