XDR-TB is associated with a much higher mortality rate than MDR-TB, because of a reduced number of effective treatment options. A 2008 study in the Tomsk oblast of Russia, reported that 14 out of 29 (48.3%) patients with XDR-TB successfully completed treatment. In 2018, the WHO reported that the treatment success rate for XDR-TB was 34% for the 2015 cohort, compared to 55% for MDR/RR-TB (2015 cohort), 77% for HIV-associated TB (2016 cohort), and 82% for TB (2016 cohort).A 2018 meta-analysis of 12,030 patients from 25 countries in 50 studies has demonstrated that treatment success increases and mortality decreases when treatment includes bedaquiline, later generation fluoroquinolones, and linezolid. One regimen for XDR-TB called Nix-TB, a combination pretomanid, bedaquiline, and linezolid, has shown promise in early clinical trials.Successful outcomes depend on a number of factors including the extent of the drug resistance, the severity of the disease and whether the patients immune system is compromised. It also depends on access to laboratories that can provide early and accurate diagnosis so that effective treatment is provided as soon as possible. Effective treatment requires that all six classes of second-line drugs be available to clinicians who have special expertise in treating such cases. Enforced quarantine
Carriers who refuse to wear a mask in public have been indefinitely involuntarily committed to regular jails, and cut off from contacting the world. Some have run away from the USA, complaining of abuse. Epidemiology
Studies have found that men have a higher risk of getting XDR-TB than women.
People infected with TB bacilli will not necessarily become sick with the disease. The immune system "walls off" the TB bacilli which, protected by a thick waxy coat, can lie dormant for years.The spread of TB bacteria depends on factors such as the number and concentration of infectious people in any one place together with the presence of people with a higher risk of being infected (such as those with HIV/AIDS). The risk of becoming infected increases with the longer the time that a previously uninfected person spends in the same room as the infectious case. The risk of spread increases where there is a high concentration of TB bacteria, such as can occur in closed environments like overcrowded houses, hospitals or prisons. The risk will be further increased if ventilation is poor. The risk of spread will be reduced and eventually eliminated if infectious patients receive proper treatment. Diagnosis
Successful diagnosis of XDR-TB depends on the patients access to quality health-care services. If TB bacteria are found in the sputum, the diagnosis of TB can be made in a day or two, but this finding will not be able to distinguish between drug-susceptible and drug-resistant TB. To evaluate drug susceptibility, the bacteria need to be cultivated and tested in a suitable laboratory. Final diagnosis in this way for TB, and especially for XDR-TB, may take from 6 to 16 weeks.The original method used to test for MDR-TB and XDR-TB was the Drug Susceptibility Testing (DST).