Towards ending tuberculosis and multidrug-resistant tuberculosis.
This 2011 update of Guidelines for the programmatic management of drug-resistant tuberculosis is intended as a tool for use by public health professionals working in response
to the Sixty-second World Health Assembly’s resolution on prevention and control of multidrug-resistant tuberculosis and e...xtensively drug-resistant tuberculosis.
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Zambia has recognised the Public Health threat of antimicrobial resistance and its impact on morbidity and mortality, as well as the subsequent economic consequences. The country has recorded microorganisms which have developed resistance to antimicrobial drugs. Notable among these are; Multidrug Re...sistant Mycobacterium Tuberculosis (MDR), Human Immunodeficiency virus resistant to antiretroviral drugs, Plasmodium resistance to antimalarial drugs, and fungal species showing indications of resistance to antifungal drugs. Emergence of “Superbugs” such as Methicillin Resistant Staphylococcus aureus (MRSA), Extended Spectrum beta-lactam (ESBL) producing Klebsiella pneumoniae and Vancomycin Resistant Enterococci (VRE) have also been reported.
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A practical tool to help health workers in the clinical and operational management of multidrug-resistant tuberculosis with special focus on the introduction, implementation and management of the nine-month treatment regimen.
A resource for the continued implementation of the Consolidated Action Plan to Prevent and Combat Multidrug- and Extensively
Drug-Resistant Tuberculosis in the WHO European Region 2011-2015
Please download the whole Document (large size 28 MB) directly from the website
Specific measures are being taken within the National Tuberculosis Control Programme (NTP) to address the MDR TB problem through appropriate management of patients and strategies to prevent the propagation and dissemination of MDR TB.
The term "Programmatic Management of Drug Resistant TB" (PMD...T) refers to programme based MDR TB diagnosis, management and treatment. This guideline promotes full integration of basic TB control and PMDT activities under the NTP, so that patients with TB are evaluated for drug resistance and are placed on the appropriate treatment regimen and properly managed from the outset of treatment, or as early as possible. The guidelines also integrate the identification and treatment of more severe forms of drug resistance, such as extensively drug resistant TB (XDR TB).
At the end, the guideline introduces new standards for registering, monitoring and reporting outcomes of multidrug resistant TB cases.
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We systematically reviewed Medline as well as the references of published review articles for relevant studies of adherence to multidrug treatment of both drug-susceptible and drug-resistant TB through February 3, 2018. We included randomized controlled trials (RCTs) as well as prospective and retro...spective cohort studies (CSs) with an internal or external control group that evaluated any adherence intervention and conducted a meta-analysis of their impact on TB treatment outcomes. Our search identified 7,729 articles, of which 129 met the inclusion criteria for quantitative analysis. Seven adherence categories were identified, including DOT offered by different providers and at various locations, reminders and tracers, incentives and enablers, patient education, digital technologies (short message services [SMSs] via mobile phones and video-observed therapy [VOT]), staff education, and combinations of these interventions.
https://doi.org/10.1371/journal.pmed.1002595
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A review of available evidence (2016).
28-29 June 2016; Geneva, Switzerland
The END TB strategy.
MMWR: Recommendations and Reports / Vol. 62 / No. 9
Morbidity and Mortality Weekly Report
October 25, 2013
HIV infection, due to the immunosuppressant that leads, nowadays constitutes an aggravating factor of endemic tuberculosis. Tuberculosis remains a huge burden to human health, even in the early 21st century. The situation is deteriorating in many countries, particularly because of the synergy with t...he HIV epidemic and the emergence of multidrug-resistant (MDR) and extensively drug resistant (XDR) tuberculosis. The urgent development of new tools that can improve the diagnosis, prevention and/or treatment of tuberculosis and other major mycobacterium diseases depends largely on the progress of basic and applied research. Faced with this situation, there is an urgent need for effective strategies and actions to permanently solve the problem of this endemic disease whose impact is too negative on people’s lives.
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In Kenya, the bacterial infections that contribute most to human disease are often those in which re-‐sistance is most evident. Examples are multidrug-‐resistant enteric bacterial pathogens such as typhoid, ... diarrhoeagenic Escherichia coli and invasive non-‐typhi salmonella, penicillin-‐resistant Streptococcus pneu-‐moniae, vancomycin-‐resistant enterococci, methicillin-‐resistant Staphylococcus aureus and multidrug-‐re-‐sistant Mycobacterium tuberculosis. Resistance to medicines commonly used to treat malaria is of particu-‐lar concern, as is the emerging resistance to anti-‐HIV drugs. Often, more expensive medicines are required to treat these infections, and this becomes a major challenge in resource-‐poor settings.
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These updates include shorter novel 6-month all-oral regimens for the treatment of multidrug- and rifampicin-resistant TB (MDR/RR-TB), with or without additional resistance to fluoroquinolones (pre-XDR-TB) as well as an alternative 9-month all-oral regimen for the treatment of MDR/RR-TB.
This Ra...pid Communication is released in advance of updated WHO consolidated guidelines expected later in 2022, to inform national TB programmes and other stakeholders of key changes in the treatment of DR-TB and to allow for rapid transition and planning at the country level.
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A practical tool to help health workers in the clinical and operational management of multidrug-resistant tuberculosis with special focus on the introduction, implementation and management of the nine-month treatment regimen.
In 2019, an estimated 10 million individuals fell ill with tuberculosis (TB) and 3 million of them were not reported to have beendiagnosed and notified. The gap is proportionately even wider for drug-resistant TB. Of the estimated 465 000 patients with rifampicin-resistant and multi-drug resistant T...B (RR/MDR-TB), only 206 030 (44%) were diagnosed and notified.For the first time, the World Health Organization (WHO) has provided global estimates of the incidence of isoniazid resistance: in 2019, there were 1.4 million incident cases of isoniazid-resistant TB, of which 1.1 million were susceptible to rifampicin. Most of these people were not diagnosed with drug-resistant TB and did not receive appropriate treatment.
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The Updated guidelines on Management of tuberculosis in children and adolescents include new recommendations that cover diagnostic approaches for TB, shorter treatment for children with non-severe drug-susceptible TB, a new option for the treatment of TB meningitis, the use of bedaquiline and delama...nid in young children with multidrug- and rifampicin-resistant TB and decentralized and family-centred, integrated models of care for TB case detection and prevention in children and adolescents.
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Tuberculosis (TB) is an infectious disease that usually affects the lungs, though it can affect any organ in the body. It can develop when bacteria spread through droplets in the air. TB can be fatal, but in many cases, TB is preventable and treatable. This report examines the human rights impact of... the prevalence of Tuberculosis (TB) and Multi-drug-resistant tuberculosis (MDR-TB) among the Indigenous San peoples of Namibia. Combining political economy and root-cause methodology, the report explores the socioeconomic factors that make the San vulnerable to TB and limit their access to adequate health services.
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Preventing tuberculosis infection from progressing to tuberculosis disease is a crucial component of the goal to eliminate tuberculosis. When deciding on the use of tuberculosis preventive therapy among household contacts, policy makers regularly ask questions, such as whether tuberculosis preventiv...e therapy is effective, safe, and feasible in a programme setting and what it will cost. For contact management and tuberculosis preventive therapy for multidrug-resistant and rifampicin-resistant tuberculosis, studies from high-income and low-income countries have shown feasibility, safety, and effectiveness.
However, there is scarce information on the cost of tuberculosis preventive therapy for multidrug-resistant and rifampicin-resistant tuberculosis. In The Lancet Global Health, Peter Dodd and colleagues show that household contact management strategies are cost-effective even in low-income and middle-income countries, which has important policy implications for achieving the END TB Strategy goals.
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