05 August 2013

MDR TB is a hidden problem in North Korea

Multidrug-resistant tuberculosis (MDR-TB) is a global problem, but one that is particularly worrisome in Asia. An estimated 60% of the 500,00 MDR-TB cases in 2011 occurred in Brazil, China, India, Russia and South Africa. The problem is made worse by the low number of people with MDR-TB enrolled in treatment in countries like China, Myanmar and India.

Information on MDR-TB in the reclusive North Korea has been hard to come by, until now. Dr. KJ Seung has been working in North Korea on TB for years and heard from his colleagues that first-line TB drugs were not working for patients.

Dr. KJ Seung in North Korea.
Dr KJ Seung
"I've treated MDR-TB in a lot of different countries, but the situation in North Korea is the worst I've ever seen," he said in a recent interview with PIH. "There are simply too many patients. At every sanatorium we visit, there are lines of patients who have failed multiple courses of treatment with regular TB drugs and are hoping to get into our treatment program."

Dr Seung decided to analyzed sputum samples from 245 of TB patients to get to the bottom of it. His results were stunning. Eighty-seven percent of the patients analyzed have MDR-TB. The results of the study were published this week in the open-access medical journal PLOS Medicine.

He collected information as a part of his work with EugeneBell, an NGO formed by US-based Eugene Bell Foundation and South Korea's EugeneBell Korea. For more than a decade, the NGOs have supported a half dozen TB sanatoria throughout North Korea. Some of the tested strains of TB were resistant to second-line drugs and there was evidence of extensively drug-resistant (XDR) TB.

"A lot of the credit has to go to Dr. Linton (director of the Eugene Bell Foundation). He's not a medical doctor, but just by listening to the North Korean doctors, he discovered a major epidemic. Sometimes the evidence is staring you in the face. You just have to listen to what people are telling you," said Dr Seung.

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