Multi-drug resistant tuberculosis remains a significant threat

Multi-drug resistant tuberculosis (MDR-TB) is defined as resistance to at least isoniazid and rifampicin. With increasing identification of this, the World Health Assembly in 2009 set the goal of ensuring that by 2015 all patients with TB receive the appropriate care to prevent, diagnose and treat MDR-TB. To assess current practice, Falzon et al (Lancet Infect Dis 2013;13:690–7) have analysed data reported to WHO by 30 countries expected to have more than 1000 MDR-TB cases. Overall, cases of MDR-TB detected in the 30 countries increased by 32% from 41 758 in 2009 to 55 134 in 2011, and enrolments on treatment for MDR-TB increased by 93%. However, only 18% of the estimated cases of MDR-TB were enrolled on second-line treatment in 2011. Twenty-three countries provided outcome data. A median of 53% (IQR 41–71%) of people had treatment success, 11% (8–17%) died, 8% (2–11%) had treatment failure, 13% (8–18%) were lost to follow-up and 4% …