The nonprofit medical humanitarian organization Médecins Sans Frontières is recommending that all patients in Swaziland who have tested positive for TB, but rapid molecular testing has found negative for drug-resistance undergo further testing, following findings that a mutation has made more than a quarter of multidrug-resistant strains undetectable by the widely used test.
MSF, its Epicentre research center and the Research Center Borstel in Germany published the findings today in a letter in The New England Journal of Medicine, and call for studies in neighboring countries to determine the prevalence of the mutation, and of similar ones.
The findings are particularly concerning in Swaziland, home to the worlds highest prevalence of HIV, and where an estimated 80 percent of TB patients are also infected with HIV. Patients with HIV are more likely than patients without HIV to have drug-resistant strains of TB.
Released the week before World TB Day on March 24, the findings highlight needs that will be reiterated throughout the anniversary of the discovery of the bacteria that causes the disease — for research that anticipates, rather than follows new challenges from tuberculosis, and programming that provides universal access to appropriate TB diagnoses and treatment.