Lancet Examines Factors Contributing to Spread of TB in Latvia

The Dec. 11 issue of the journal Lancet examined how poverty, unemployment and a "chaotic" health system in Latvia have contributed to the spread of drug-resistant strains of tuberculosis. After Latvia split from the Soviet Union in 1991, the country was "plunged into chaos" as its gross domestic product fell to almost half of its previous levels, unemployment rates "soared" and poverty became widespread, according to the Lancet. These factors "helped spur a resurgence of diseases that had been kept strictly under control by the centralized Soviet health system," the Lancet reports. Currently, Latvia has one of the highest rates of drug-resistant TB in the world, and the "ferocity of the disease's resurgence ... means that it could be a long time before the epidemic retreats," according to the Lancet. [D]octors in Latvia say the government should focus its efforts on the country's "overstretched" prison system, as approximately two-thirds of TB patients in 2003 contracted the disease after being incarcerated (Brown, Lancet, 12/11).