Drastic Reduction in TB

Faces Tough Challenges

From drug-resistant tuberculosis in California to high disease rates in South African gold mines, stubborn challenges threaten health officials' goals for drastically reducing TB globally within 10 years, several studies show.

Many public health officials worldwide are using a World Health Organization-recommended approach to halve TB prevalence and death rates between 1990 and 2015, said a report in today's Journal of the American Medical Association.

The strategy includes standard drug treatment, a system to ensure regular drug supplies, a standard reporting system and political commitment to tackling the threat.

Despite falling rates in some developed nations, including the United States, TB still affects more than 8 million people worldwide annually -- slightly more than in 1991 -- and kills about 2 million people, mostly in Asia and Africa, several JAMA reports said.

"Tuberculosis continues its 3,000-year history of decimation," said an editorial by Catherine DeAngelis, JAMA editor in chief, and Annette Flanagin, managing deputy editor, who devoted this week's edition to tuberculosis reports.

As of 2003, the global incidence rate continued to rise by about 1 percent yearly, and U.S. cases will never be eradicated unless the disease is eliminated elsewhere, the reports said. Most U.S. cases occur in foreign-born people.

A WHO report in JAMA said reduction of TB incidence could be achieved in most of the world by 2015, but that the challenge will be greatest in Africa and Eastern Europe because of HIV-AIDS and drug resistance.

Woman Gives Birth

After Ovary Transplant

A woman whose ovaries stopped working when she was a teenager has given birth to a girl after an ovary transplant from her identical twin sister, doctors in St. Louis said yesterday.

Three months after the operation, the 24-year-old woman began having normal menstrual cycles, and she became pregnant two months later, according to the medical team led by Sherman J. Silber of St. Luke's Hospital.

The surgery, which doctors said would probably remain rare, came after two failed attempts at test tube fertilization using eggs donated by her sister.

The successful outcome, Silber's team said, may improve the prospects for female cancer patients facing treatments that could make them sterile to freeze their ovary tissue in advance and reimplant it later to restore their fertility.

Details of the operation, scheduled to be published next month in the New England Journal of Medicine, were posted on the Journal's Web site, www.nejm.org.

-- From News Services