Valerie Blackburn, 2006

Here’s a window into why tuberculosis is so devilishly hard to treat and eradicate.

The Sept. 7 “Bulletin of the World Health Organization” explains how researchers in Tomsk, Siberia, studied success and adherence to treatment among  a group of 237 Siberians.

The Russian Federation has been hit hard by TB, and Tomsk had one of the world’s highest rates of multi-drug-resistant TB.

Substance abuse was strongly correlated with non-adherence to treatment, researchers found.

No surprise to me, but this is documented, not conjecture.

Patients who began treatment in the hospital or were hospitalized during their treatment were more likely to develop drug-resistant TB.  Researchers speculated the patients harbored a drug-resistant strain that emerged upon treatment or contracted the strain while hospitalized.

I’m sure there are similar studies published elsewhere, and I wouldn’t be surprised if they say the same thing.

Drug-resistant TB and sloppy adherence or lack of adherence to treatment go hand in hand. While this study was interesting for looking at the correlation with alcohol use and other substance abuse, the same likely would apply to many of Americans who are most vulnerable to TB — especially IV drug users.

Although researchers are working in quicker-course TB drugs, the current drugs take months and must be taken regularly. In the past, sufferers were locked in sanatoriums. Today, they’re followed by health department personnel, not an easy task when the person is transient.

A positive point emerged from the study, too: Most patients completed treatment, and relatively few contracted drug-resistant TB.

 Something to think about.

Jeff Raymond, Medical Writer