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Development of a standardised tool to survey MDR-/XDR-TB case management in Europe

Sotgiu, Giovanni and Centis, Rosella and D’Ambrosio, Lia and De Lorenzo, Saverio and Richardson, Morgan D’Arcy and Lange, Christoph and Manissero, Davide and Migliori, Giovanni Battista (2010) Development of a standardised tool to survey MDR-/XDR-TB case management in Europe. European Respiratory Journal, Vol. 36 (1), p. 208-211. eISSN 1399-3003. Article.

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Abstract

The emergence of multidrug-resistant tuberculosis (MDR-TB, defined as in vitro resistance to isoniazid and rifampicin) 1–5 and extensively drug-resistant TB (XDR-TB, defined as in vitro drug resistance to isoniazid and rifampicin plus any fluoroquinolone and at least one of the injectable drugs: capreomycin, kanamycin or amikacin) represents a major threat to TB control at the global level 1–5.
In 2007, the World Health Organization (WHO) estimated a prevalence of 511,000 MDR-TB cases (with 150,000 deaths) and 50,000 XDR-TB cases (and 30,000 deaths) 1; 14 out of 19 high-MDR-TB burden territories are located in Former Soviet Union (FSU) countries 1.
XDR-TB is a manmade product, resulting, in essence, from clinical mismanagement of newly diagnosed pan-susceptible TB cases as well as MDR-TB cases 1, 2. There is evidence that suboptimal TB case management in parts of Europe contributes to the development of resistance to the XDR-TB defining drugs 4–7.
In spite of the growing amount of public awareness about TB drug resistance, the essential variables necessary to fully understand MDR-TB and XDR-TB are unfortunately not systematically collected, analysed and reported in published studies 2, 8. Although the international community is providing a rapid response to XDR-TB (formulation of an emergency plan 9; development of an instrument to support implementation and scale-up of national strategies and to assess programmatic needs 10), no standardised and comprehensive tool is available to survey the key factor responsible for the emergence of MDR-/XDR-TB: inappropriate TB case management.

Item Type:Article
ID Code:4945
Status:Published
Refereed:Yes
Uncontrolled Keywords:Survey, M/XDR
Subjects:Area 06 - Scienze mediche > MED/01 Statistica medica
Divisions:001 Università di Sassari > 03 Istituti > Igiene e medicina preventiva
Publisher:European Respiratory Society Journals
eISSN:1399-3003
Deposited On:24 Nov 2010 11:31

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