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How Can We Overcome The Barriers To Treating Drug-resistant TB?

Date:
July 10, 2008
Source:
Public Library of Science
Summary:
Almost 1 in 20 cases of tuberculosis worldwide is resistant to multiple drugs (known as multidrug-resistant TB or MDR-TB) and the World Health Organization has called for a massive scale up in public health efforts to tackle these cases. Now a group of MDR-TB experts outlines its recommendations on conducting research that would help in the scale up.
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Almost 1 in 20 cases of tuberculosis worldwide is resistant to multiple drugs (known as multidrug-resistant TB or MDR-TB) and the World Health Organization has called for a massive scale up in public health efforts to tackle these cases. Now a group of MDR-TB experts outlines its recommendations on conducting research that would help in the scale up.

MDR-TB can be effectively treated using second-line TB drugs, though these drugs are more expensive, less potent, and less well tolerated than first-line drugs. Fewer than 2% of all patients with MDR-TB are receiving appropriate second-line treatment. The WHO has therefore called for a dramatic scale up of MDR-TB treatment as a routine component of TB control, setting a target of treating 1.6 million patients with MDR-TB by 2015. Pilot projects of MDR-TB management (known as "programmatic management of drug-resistant TB" or PMDT) in five low income settings showed treatment success rates of 59%-83%.

Frank Cobelens (KNVC Tuberculosis Foundation) and colleagues, writing on behalf of the Working Group on MDR-TB of the Stop TB Partnership, lay out their "prioritized research agenda." The agenda identifies the most important barriers to scaling up the treatment of MDR-TB and prioritizes the research questions to be addressed to overcome these barriers.

Their research priorities include:

  • new and improved tools for testing patients to see if they have drug-resistant TB
  • clinical trials of simplified and shorter second-line treatments for MDR-TB
  • new and improved strategies for diagnosis of drug-resistant TB, for helping patients complete the whole course of drug treatment, and for controlling the spread of the infection
  • understanding geographic variations in the occurrence of drug resistance
  • clinical trials to test whether giving TB drugs to people who came into contact with patients with drug-resistant TB prevents them from developing resistant TB.

With increasing recognition of drug-resistant TB worldwide, say Cobelens and colleagues, "the time has come to move PMDT in resource-limited settings beyond the limited, pilot project phase."


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Public Library of Science. "How Can We Overcome The Barriers To Treating Drug-resistant TB?." ScienceDaily. ScienceDaily, 10 July 2008. <www.sciencedaily.com/releases/2008/07/080707222323.htm>.
Public Library of Science. (2008, July 10). How Can We Overcome The Barriers To Treating Drug-resistant TB?. ScienceDaily. Retrieved August 3, 2015 from www.sciencedaily.com/releases/2008/07/080707222323.htm
Public Library of Science. "How Can We Overcome The Barriers To Treating Drug-resistant TB?." ScienceDaily. www.sciencedaily.com/releases/2008/07/080707222323.htm (accessed August 3, 2015).

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