Abstract
Multiple-drug-resistant tuberculosis (MDR-TB) is a serious global clinical, microbiological and public health problem. The World Health Organization-International Union Against Tuberculosis and Lung Disease Programme on Drug Resistance has reported data from 35 countries demonstrating that MDR-TB is widespread. One-third of countries had levels above 2% in new patients. Drug resistance, including MDR-TB, is caused by non-adherence to therapy, inappropriate treatment regimens, drug malabsorption and poor health infrastructure needed for the effective delivery of treatment. Individual risk factors for MDR-TB include prior TB therapy and human immunodeficiency virus infection. The key elements of a successful TB programme are the early detection of cases, particularly the most infectious and those infected with drug-resistant strains, combined with successful treatment using standardized regimens. Countries with poor TB control programmes have a higher prevalence of MDR-TB: a successful programme limits MDR-TB prevalence. MDR-TB treatment requires individualized therapy based on in vitro drug susceptibility testing.
| Original language | English |
|---|---|
| Pages (from-to) | 243-268 |
| Number of pages | 26 |
| Journal | Bailliere's Clinical Infectious Diseases |
| Volume | 5 |
| Issue number | 2 |
| Publication status | Published - 1999 |
Bibliographical note
Funding Information:This work was supported by Grant No. KO7 HL 3057–03 from the National Institutes of Health, and Grant No. PO HC96000892 from the Centers for Disease Control and Prevention.
Copyright:
Copyright 2004 Elsevier Science B.V., Amsterdam. All rights reserved.
Keywords
- Directly observed therapy
- Human immunodeficiency virus
- Multiple-drug-resistant tuberculosis
