**Author details**

*Molecular Epidemiology Study of Mycobacterium Tuberculosis Complex*

resistance [5].

in the Caribbean countries.

**6. Conclusion**

resistant TB infections.

achieve eradication.

the genealogy of the mycobacteria in those territories [5]. For example, Peru showed a large number of tuberculosis strains very similar to those found on Beijing, compatible with a well-known historical Chinese migration to that country. Those genetic origins allow the mycobacteria to have different virulence, increasing its capability to survive and being transmitted between hosts. Those mycobacteria have developed the capability to survive the immune response of the host, the external environment in the droplet and particles transmitted, and an increase capability to cause active disease, increasing the probability of population spread. This environmental resistance conferred to those genetically more fitted strains has been associated with an increased risk of developing drug

Again, data is scarce in the specific prevalence of MDR-TB in all regions of the Caribbean. However extremely high incidence of tuberculosis in territories such as Haiti and Dominican Republic have overlap with a high rate of co-infection with Human Immunodeficiency Virus (HIV). The degree of immunosuppression contribute to the developing of active disease, population spreading of infection, and dissemination of selected tuberculosis strains, including those which are drug resistant. High prevalence of other conditions such as COPD and diabetes also contribute to the tuberculosis spread and the development of drug resistant infection. In addition, the limited access and poor quality of health care services, malnutrition, poverty and underprivilege living conditions are associated to the spread of tuberculosis throughout populations [18]. All of those factors are highly prevalent

Limited healthcare and economic resources, inadequate exposure to anti tuberculosis drug regimens and specific characteristics of the infected host, have paved the long way to the genetic inheritance of resistant strains of tuberculosis to develop and propagate in this side of the world. Migratory patterns from Europa and Asia to the Latin American territories have brought tuberculosis strains with genes capable of resists specific drugs, but it has been the inadequate use of medication and the exposures in these lands that have allowed the genetic transformation of bacteria in the populations. As Peru did in decade of 1990, establishing direct observation therapy programs help significatively to decrease the prevalence of MDR-TB strains in the population [14]. Also, prevention of TB spread with rapid diagnosis and screening in high risk populations is a pivotal way to decrease the surge of new cases. The global use of the new genetic rapid tests for detecting drug resistant strains of TB [4] is another way for eradication of MDR-TB. Most important, is to increase population's access to appropriate therapy for those with sensitive and

The reach for better healthcare systems, population awareness, programs for better screening and assurance of adequate treatment for tuberculosis patients will be the only infallible tool to decrease the rate of MDR-TB infections and the way to

**60**

Onix J. Cantres-Fonseca\* and Francisco Del Olmo-Arroyo VA Caribbean Health System, San Juan, Puerto Rico

\*Address all correspondence to: onixcantres@gmail.com

© 2021 The Author(s). Licensee IntechOpen. This chapter is distributed under the terms of the Creative Commons Attribution License (http://creativecommons.org/licenses/ by/3.0), which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.
