Surveillance of anti-tuberculosis drug resistance in the world: an updated analysis, 2007-2010

objective: to present a global update of drug-resistant tuberculosis (tb) and explore trends in 1994-2010. methods: data on drug resistance among new and previously treated tb patients, as reported by countries to the world health organization, were analysed. such data are collected through surveys of a representative sample of tb patients or surveillance systems based on routine drug susceptibility testing. associations between multidrug-resistant tb (mdr-tb) and human immunodeficiency virus (hiv) infection and sex were explored through logistic regression. findings: in 2007-2010, 80 countries and 8 territories reported surveillance data. mdr-tb among new and previously treated cases was highest in the russian federation (murmansk oblast, 28.9%) and the republic of moldova (65.1%), respectively. in three former soviet union countries and south africa, more than 10% of the cases of mdr-tb were extensively drug-resistant. globally, in 1994 to 2010 multidrug resistance was observed in 3.4% (95% confidence interval, ci: 1.9-5.0) of all new tb cases and in 19.8% (95% ci: 14.4-25.1) of previously treated tb cases. no overall associations between mdr-tb and hiv infection (odds ratio, or: 1.4; 95% ci: 0.7-3.0) or sex (or: 1.1; 95% ci: 0.8-1.4) were found. between 1994 and 2010, mdr-tb rates in the general population increased in botswana, peru, the republic of korea and declined in estonia, latvia and the united states of america. conclusion: the highest global rates of mdr-tb ever reported were documented in 2009 and 2010. trends in mdr-tb are still unclear in most settings. better surveillance or survey data are required, especially from africa and india.