Epidemiology of multidrug-resistant, extensively drug resistant, and totally drug resistant tuberculosis in Middle East countries

The 2015 represent the deadline for the global tuberculosis [TB] targets set through the Mil-lennium Development Goals [MDG]

From 2016 and onward, new goals were set to end the global TB epidemic via implementing new campaign entitled [the End TB Strategy]

The major hurdle to end TB epidemic in several parts of the world is the emergence and spread of drug resistant Mycobacterium tuberculosis [MTB] strains. The better understanding of the actual global burden of drug resistant tuberculosis would feed into better implementing the End TB Strategy. In this article we summarize the current knowledge on the patterns of drug resistance tuberculosis cases in the Middle East countries. These countries are served by the Eastern Mediterranean Regional Office [EMRO], one out of six regional offices of World Health Organization. Middle East countries are characterized by geographic vicinity and population's interaction. However, they are dissimilar in several aspects such as economy and health infrastructures. Regarding economy, countries in this region are ranging from wealthy to very poor. Prevalence of tuberculosis and patterns drug resistance tuberculosis cases are also following variable trends within countries of this region. In almost all Middle East countries, there is under-reporting of drug-resistance tuberculosis cases

There are shortages in the infrastructures and facilities for detecting the pattern of drug-resistance tuberculosis. For instance, sixout of 14 countries have neither in-country capacity nor a linkage with a partner laboratory for second-line drug susceptibility testing and only 4 countries have registered site performing Xpert MTB/RIF

Childhood respiratory tuberculosis in Iran

To estimate the bacterio-epidemiological situation of childhood respiratory tuberculosis in Iran, 2185 symptomatic patients of 0-14 years old were studied. Among 110 bacteriologically confirmed cases, 60% were less than five years old and the number of females was slightly more than males. In 21% of patients, the Mantoux test was negative. None of the miliary cases had a history of BCG vaccination. In 54.6% of patients less than two years old, one of the family members was suffering from infectious tuberculosis. Clinical findings were fever, cough, weight loss and respiratory distress respectively. Radiological findings were mostly pneumonia or bronchopneumonia-like infiltrations and in 44% of cases were found in the right lung. Mycobacterium tuberculosis strains in 11.7% of patients were resistant to isoniazid or streptomycin

clinical and immunological comparative study on 522 breast-fed children

Until now, there have been various studies concerning bottle-fed and breast-fed children. Prevalence of allergic manifestations like eczema and asthma among bottle-fed children is much higher than healthy controls. In this study, we found that respiratory infection for breast-fed children was 3.1%, whereas in bottle-fed children it was 25.1% ;for gut disorders, 9.2% in breast-fed vs. 13.1% for bottle-fed children; eczema 22.9% in breast fed and 33.3% in bottle-fed children; while asthma was 14.5% in breast-fed and 26% in bottle-fed children. We conclude that prevalence of respiratory, allergic and GI tract infections are much higher in bottle-fed infants than in breast-fed ones. This is somewhat in contradiction to that of American and European reports