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Inexpensive treatment stops multi-drug resistant TB in its tracks

A standard and inexpensive tuberculosis treatment regimen cut the overall TB rate in half and lowered the rate of drug-resistant cases even more dramatically in a remote Mexican health district with a high prevalence of the disease. "This shows what basic TB control can accomplish," said Maria de Lourdes Garca Garca, a Howard Hughes Medical Institute international research scholar who led the Mexican study.

To learn more about TB transmission in less developed countries, Garca Garca and colleagues from the National Institutes of Mexico and Stanford University launched a five-year study in the Orizaba Health Jurisdiction, four hours by bus southeast of Mexico City. The district, which has a higher rate of TB than Mexico as a whole, encompasses five mostly urban communities in an industrialized valley and surrounding rural mountains.

Supported by HHMI, the U.S. National Institutes of Health, and the Wellcome Trust, the study used modern molecular epidemiologic approaches, in addition to screenings, clinical assessment of people reporting symptoms, supervised treatment, and follow-up, to explore a global health problem.

At the outset, 22 percent of previously untreated patients with pulmonary TB were carrying drug-resistant strains, and 6.7 percent had multiple-drug resistance. By the study's final year, only 7.8 percent of new TB patients carried drug-resistant strains, and there were no cases of multiple-drug resistant TB.

The researchers report their findings in the April 2, 2005 issue of the British medical journal The Lancet. A commentary by Marcos Espinal, executive secretary of the World Health Organization's Stop TB Partnership, appears in the same issue.

People with TB must take four standard drugs daily for six months. They may begin to feel better after a month, which tends to lead them to skip doses, but if they stop taking the drugs for any reason, the drugs may become ineffective and multi-drug resistant TB may
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Contact: Cindy Fox Aisen
aisenc@hhmi.org
317-843-2276
Howard Hughes Medical Institute
31-Mar-2005


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