Rising Trends of Multidrug Resistant (MDR) Tuberculosis In Pakistan

Ahsan Sattar Sheikh*¹, Mubashar Aziz² and Mazhar Ayaz²

Received: December 07, 2018;   Published: December 20, 2018

DOI: 10.26717/BJSTR.2018.12.002509

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Abstract

Worldwide more than 10.4 million persons are infected with Mycobacterium species – the causative agent each year. Of these all, 1.7 million patients loss their life each year. Patients with tuberculosis (TB) come from low and middle income countries. Today this active surge in TB cases comes from 22 high burden countries (HBC). To date, Mycobacterium species whether they are conventional or non-conventional TB, its spread within worldwide geographic regions / countries doesn’t show any traceable genetic mechanism of evolution. With this world health authorities projects emergence of more than 600 thousand new antibiotic resistant cases to first line primary drugs in Anti Tuberculosis Therapy (ATT) in HBC. It is calculated that from all world rifampicin resistant TB, 47% of these patients live India, Pakistan, China and Russian Federation. In the first Pakistan National Anti-Tuberculosis Drug Resistance survey reports (2012-2013) indicates that Pakistan has 3.6% MDR – TB cases. Pakistan is included in seven countries that shares more than 2/3 of all diagnosed cases. In the high burden countries several socio-economic and biological factors including poverty, place of residence, place of consultation, level of education, wait time for available health care facility contribute to emerging trends in chemotherapy appliance.

In the Sustainable Development Goals (SDGs) devised by world agencies drills to all nations to End TB by 2035. Recently, PCR based GenoType MTBD plus assay for MDR cases show mutations at position G944C with S315T amino acid changes. In recent years development of miRNA against several transcriptional factors have been identified. Some other microRNAs include miR-204 that have shown to effect on signalling pathways for pulmonary arterial smooth muscle cells activities

Abbreviations : TB: Tuberculosis; ATT: Anti Tuberculosis Therapy; HBC: High Burden Countries; SDGs: Sustainable Development Goals; MIRU-VNTR: Interspersed Repetitive Units – Variable Number of Tandem Repeats; MDR-TB: Multi Drug Resistant -TB; BAL: Broncho alveolar lavage; GA: Gastric Aspiration; TBIC: TB Infection Control