“Treatment for LTBI still relies heavily on isoniazid, either as monotherapy or as part of a combination regimen,” wrote the authors in the study. “We found that just under 11% of all recent Mtb
infections are likely to be isoniazid-resistant, with much higher rates in some regions, and this proportion is likely to increase. While less common, rifampicin resistance also has the potential to threaten the usefulness of rifampicin-containing prophylactic regimens. New treatments that bypass the rising resistance to isoniazid and rifampicin are needed to fully operationalize interventions to test and treat LTBI.”
In the study, the researchers found LTBI was most prevalent in Southeast Asia, the Western Pacific, and African regions, which together accounted for 80% of all latent TB cases. The Americas, Europe, and Eastern Mediterranean regions had a low rate of latent TB of less than 17%.
Based on their findings, the authors noted that current latent infection rates coupled with the active TB disease cases likely to arise pose a serious challenge for the goals set by the End TB Strategy. They call for updated policies, improved diagnostic and testing, a vaccine to prevent the progression of latent infection to active TB, and better social and economic conditions to make significant reductions in TB disease worldwide.
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