Without new interventions, cases of extensively drug-resistant tuberculosis (XDR-TB) in rural South Africa will increase dramatically over the next five years, according to a study.

The research was published last week (27 October) in The Lancet.

The study, which modelled the effect of various infection control measures on the spread of XDR-TB in the rural community of Tugela Ferry in KwaZulu-Natal, South Africa, suggests that infection rates will increase from 194 cases in 2007 to an estimated average of 234 cases a year by 2012.

Multidrug-resistant TB will also increase from 352 cases in 2007 to 425 a year over the same period.

They estimate that 72–96 per cent of all new XDR-TB cases in Tugela Ferry will occur in people infected with HIV.

The scientists claim that more than half the airborne infections of XDR-TB — tuberculosis that is resistant to both first-line and specific second-line drugs — would occur within hospitals.

The study suggests that a combination of controls — including using masks, reducing hospitalisation time, improving ventilation and rapid drug resistance testing — could avert almost half the predicted XDR-TB cases by 2012 at Tugela Ferry and at similar resource-limited hospitals around the country.

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