New World Health Organization (W.H.O.) Guidelines to Manage Drug Resistant Tuberculosis

xdr tb

 

A new document 'The WHO guidelines for the programmatic management of drug-resistant tuberculosis: 2011 update' has been published today in the European Respiratory Journal. It focuses on areas of importance for healthcare professionals in the diagnosis, treatment and care of drug-resistant TB. It also calls upon the scientific community to do more research in the field of management of this difficult condition.
 
Tuberculosis is a pandemic caused by Mycobacterium Tuberculosis which spreads from an infected person to a healthy person by inhaling air containing the bacteria. The disease primarily involves the lungs though it may spread to other parts of the body as well. TB is a grave disease responsible for the death of as many as 1.7 million people in 2009 alone. The figure does not include the cases of AIDS which ultimately died of TB. When TB does not respond to the conventional treatment, it is called as drug resistant and multidrug resistant TB.
 
The new set of guidelines for treating drug resistant TB, issued by WHO, has been formulated by top experts in the field after analyzing the best scientific literature available on the topic. The guidelines cover important aspects of the management of TB including diagnosis, treatment, monitoring and cost-effectiveness of different models of care. They have been devised to help in making early diagnosis and strengthening patient care, especially in the lower income families of developing countries. Some of the key recommendations for action to be taken by clinicians and public health decision makers include:
 
A wider use of rapid drug susceptibility testing for isoniazid and rifampicin or rifampicin alone upon patient diagnosis with TB and before treatment initiation.
More focus to be laid on ambulatory models of care rather than hospitalization of the patients.
Patients with MDR-TB should receive an intensive phase of treatment lasting for at least 8 months' duration.
 
One noticeable change from the earlier set of guidelines issued in 2008 is that the recommended minimum duration of treatment with injectable drugs has been extended by 2 months. The authors of the guidelines have called for more research into the ideal length and combination of drugs so as to increase the chances of successful treatment of patients with multidrug resistant TB.
 
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Date: 
Sunday, September 14, 2014