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OET READING PART B

 1.The paragraph implies that


A) financial implications of multidrug-resistant tuberculosis treatment

B) effects of change from acquired to primarily transmitted disease.

C) resistance to multidrug-resistant tuberculosis therapy.


MULTIDRUG- RESISTANT TUBERCULOSIS.


With an estimated 480 000 new cases developing every year,multidrug-resistant tuberculosis is one of the greatest public health challenges worldwide. Multidrug-resistant tuberculosis is much more common in patients who have previously been treated for tuberculosis,and public health efforts have typically focused on high-quality treatment of drug-susceptible tuberculosis to prevent acquisition of resistance while on therapy. However, a substantial proportion of patients with multidrug-resistant tuberculosis might have transmitted drug resistance (ie, present before treatment begins), and drug resistance is therefore often the cause of treatment failure, not the result. Several studies have illustrated how, as multidrug-resistant tuberculosis epidemics take hold in populations, most multidrug-resistant tuberculosis cases can shift from being acquired during treatment to primarily transmitted. At least one modelling analysis suggests that this transition has already taken place in have important implications for public health efforts: once multidrug-resistant tuberculosis becomes a primarily transmitted disease, improving the effectiveness of drug-susceptible tuberculosis treatment can no longer contain the spread of resistance, and public health efforts must shift to diagnosis and treatment of multidrug-resistant tuberculosis. As the cost of multidrug-resistant tuberculosis treatment can exceed that of first-line tuberculosis therapy by a factor of ten or more,the resource implications of this epidemiological shift are profound.



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