CDC/Emory/NIH study published in The New England Journal of Medicine adds to growing body of evidence that extensively drug-resistant TB is fueled more by direct transmission than previously thought in high-burden settings. A study published today in The New England Journal of Medicine provides compelling evidence that extensively drug-resistant tuberculosis (XDR TB) is spreading from person-to-person in the province of KwaZulu-Natal, South Africa from 2011–2014. The study was conducted by a team of researchers from Emory University, the U.S. Centers for Disease Control and Prevention, Albert Einstein College of Medicine, and the University of KwaZulu-Natal in South Africa and was funded by the National Institutes of Health.
The study found that the majority of cases (69 percent) in high HIV- and high TB-burden areas of the region happened due to person-to-person transmission rather than inadequate TB treatment. By using an innovative social networks analysis, the study identified numerous opportunities for transmission in both hospitals and community settings, such as households and workplaces. The study has important implications for the prevention and treatment of drug-resistant TB, including a need for greater focus on infection control efforts while also maintaining global programs to quickly detect and effectively treat all people with TB.