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SA Causing XDR TB Via
Poor Drug-Regimen For TB+HIV
By Adriana Stuijt
Exclusive To Rense.com
The authoritative medical publication, "The Lancet's Infectious diseases magazine" has just published an article in which top XDR- TB-experts strongly urge that drug-resistant-tuberculosis patients be treated in seperation from all other "susceptible individuals" in the same health-care facilities because they remain highly infectious.
These experts also noted that the co-infected TB+HIV patients in South Africa are only given two drugs due to the government's policies -- and that this poor-medication practice 'increases their drug-resistance." The article urges the SA government to most urgently provide more second-line TB drugs to such patients to 'avert this drug-resistance-problem."
"The Lancet"'s article emphasises the scientific findings of doctors in the field in South Africa that "poor prescribing practices" are an emerging problem of extensively drug-resistant (XDR) tuberculosis:
link to entire original research document:
http://www.thelancet.com/journals/laninf/article/ PIIS1473309906706041/fulltext
This article notes that 'although improved tuberculosis medication handling is essential, the largest study to date of XDR tuberculosis (in South Africa's present epidemic) shows that those infected with the disease were never exposed to second-line (tuberculosis) drugs and most had never been treated for tuberculosis." Source link for above paragraph:
http://www.thelancet.com/journals/lancet/article/ PIIS0140673606695731/fulltext
"At least in this locale, XDR tuberculosis is not simply a problem of acquired drug resistance," the magazine article warns."Rather, afflicted patients were severely immunocompromised as a result of HIV infection (with a median CD4 count of 63 cells per mL) and were infected with XDR tuberculosis via primary transmission, perhaps in a nosocomial setting". (In other words these patients were infected as a result of treatment in a hospital-like setting).
source links for above paragraph: "Médecins Sans Frontières. Difficulties in procurement of second-line anti-tuberculosis drugs, May 22 2007:
The Lancet writes:
"Therefore, to promote proper standards of tuberculosis care, those concerned about drug resistance should emphasise appropriate treatment for HIV and the separation of drug-resistant tuberculosis patients from susceptible individuals. "Interventions against XDR tuberculosis should also consider drug misuse, but in the sense that limited availability should be regarded as a form of such misuse.
"South African XDR-TB patients moreover, are also showing increased drug-resistance because these patients are only given two active agents due to 'poor medication access', according to personal statements to The Lancet which were made by doctors at the Church of Scotland Hospital in KwaZulu-Natal, and health-care workers at the Philanjalo HIV-Aids organisation (which treats patients in their homes). All these field-care health workers are warning in this article that "this (lack of medication access) will undoubtedly amplify drugs resistance". The Lancet comments that this (growing drug-resistance) "may be averted by accelerating access to second-line agents (drugs) for use in bolstered regimens."
source links for above paragraph:
"Therefore, to truly control a problem such as XDR tuberculosis, careful examination of the available data and current state of treatment efforts in the affected regions is required, rather than assuming that all drug resistance problems can be easily generalised."
http://www.thelancet.com/journals/laninf/article/ PIIS1473309907701421/fulltext?



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