THE EPIDEMIOLOGY OF TUBERCULOSIS AND RESI STANCE TO ANTITUBERCULOSIS DRUGS

Tuberculosis is once more a subject of world wide preoccupation; since 1985 a disturbing recrudescence of this disease has been noted in num erous countries related to population growth and the worsening of pove rty in those countries without natural resources, and disadvantaged gr oups living on the margins of society in rich countries, along with th e occurrence of an epidemic of HIV (VIH). In numerous developed countr ies where tuberculosis no longer represents a public health problem, t he care services have little by little been closed or re-oriented and the principles of treatment of tuberculosis have been forgotten. The d irect consequence of this has often been inadequate treatment and its corollary; the emergence of strains multiresistant to Isoniazid and Ri fampicin. If the current epidemiological tendencies are confirmed and no supplementary action is taken, the WHO (OMS) has estimated that dur ing the ten years between 1990 and the millennium there will be 88 mil lion new cases of tuberculosis and 30 million people will die of tuber culosis. However the tendencies can be reversed and tuberculosis could still be eliminated. The struggle against tuberculosis is a world wid e emergency and the hope of controlling the situation before an increa se in multiresistant strains which would render the trend irreversible , rests on a general application of correct and coherent national prog rammes. Such a programme as the UICTMR model had already been carried out as has the proof of their efficacy.