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The emergence of extensively drug-resistant strains of tuberculosis, especially in countries with a high prevalence of human immunodeficiency virus, is a serious threat to global public health and jeopardizes efforts to effectively control the disease. This publication offers updated recommendations for the diagnosis and management of drug-resistant tuberculosis in a variety of geographical, economic and social settings, and the recording of data that enables the monitoring and evaluation of programs.--Publisher's description.
The book titled “Management of Multi-Drug Resistant TB Treatment: Social Work Perspective” focuses on describing the background characteristic of persons affected by Multi Drug-Resistant TB and their psycho-social well-being, socio-economic condition, general health status, psychological distress and self-stigma and how it has to be enhance the coping and resilience among the patients with Social Work intervention methods based on the evidences in the field and it is sub-divided into fifteen chapters based on the broad themes. It offers an extensive research evidences about the Multi-Drug Resistant TB Treatment and wide range of strategies and professional skills and knowledge based on the field expertise for prevention, promotion and curative aspects. The book is forward thinking, anticipating and outlining potentially important directions for the future of social work practitioners in the field of management of Multi-Drug Resistant TB Treatment as well as academicians’ and for research field. Finally, the book sheds light on the collective wisdom that has been accumulated through wide variety of literature, interventional strategies and management of Multi-Drug Resistant TB Treatment will be beneficial those who have been influential in the field of practice.
Tuberculosis (TB) strains with drug resistance (DR-TB) are more difficult to treat than drug-susceptible ones, and threaten global progress towards the targets set by the End TB Strategy of the World Health Organization (WHO). There is thus a critical need for evidence-based policy recommendations on the treatment and care of patients with DR-TB, based on the most recent and comprehensive evidence available. In this regard, the WHO consolidated guidelines on drug-resistant tuberculosis treatment fulfil the mandate of WHO to inform health professionals in Member States on how to improve treatment and care for patients with DR-TB. Between 2011 and 2018, WHO has developed and issued evidence-based policy recommendations on the treatment and care of patients with DR-TB. These policy recommendations have been presented in several WHO documents and their associated annexes, including the WHO treatment guidelines for multidrug- and rifampicin-resistant tuberculosis, 2018 update, issued by WHO in December 2018. The policy recommendations in each of these guidelines have been developed by WHO-convened Guideline Development Groups (GDGs), using the GRADE (Grading of Recommendations, Assessment, Development and Evaluation) approach to summarize the evidence, and formulate policy recommendations and accompanying remarks. The present Consolidated guidelines include a comprehensive set of WHO recommendations for the treatment and care of DR-TB, derived from these WHO guidelines documents. The consolidated guidelines include policy recommendations on treatment regimens for isoniazid-resistant TB (Hr-TB) and MDR/RR-TB, including longer and shorter regimens, culture monitoring of patients on treatment, the timing of antiretroviral therapy (ART) in MDR/RR-TB patients infected with the human immunodeficiency virus (HIV), use of surgery for patients receiving MDR-TB treatment, and optimal models of patient support and care.
Multidrug-resistant tuberculosis (MDR-TB) and extensively drug-resistant tuberculosis (XDR-TB) are increasingly encountered in resource-limited settings. In the context of a national response to MDR- and XDR-TB, health workers in TB clinics (in district hospitals and some accredited health centers) will need to diagnose MDR-TB, initiate second-line anti-TB drugs, and monitor MDR-TB treatment. This Field Guide was created to help health workers carry out these tasks. It is a job aid that medical officers and TB nurses are meant to use frequently during the day for quick reference. It is based on the Emergency Update 2008 of Guidelines for Programmatic Management of Drug-resistant Tuberculosis, and may be considered a companion document to these guidelines. It also draws on the experience of the international health NGO Partners In Health (PIH) in many countries. This module should be introduced to health workers in the context of a training course with a strong emphasis on TB-HIV co-management.
Between 2011 and 2019, WHO has developed and issued evidence-based policy recommendations on the treatment and care of patients with DR-TB. These policy recommendations have been presented in several WHO documents and their associated annexes, including the WHO Consolidated Guidelines on Drug Resistant Tuberculosis Treatment, issued by WHO in March 2019. The policy recommendations in each of these guidelines have been developed by WHO-convened Guideline Development Groups, using the GRADE (Grading of Recommendations, Assessment, Development and Evaluation) approach to summarize the evidence, and formulate policy recommendations and accompanying remarks. The present WHO Consolidated Guidelines on Tuberculosis, Module 4: Treatment - Drug-Resistant Tuberculosis Treatment includes a comprehensive set of WHO recommendations for the treatment and care of DR-TB. The document includes two new recommendations, one on the composition of shorter regimens and one on the use of the BPaL regimen (i.e. bedaquiline, pretomanid and linezolid). In addition, the consolidated guidelines include existing recommendations on treatment regimens for isoniazid-resistant TB and MDR/RR-TB, including longer regimens, culture monitoring of patients on treatment, the timing of antiretroviral therapy (ART) in MDR/RR-TB patients infected with the human immunodeficiency virus (HIV), the use of surgery for patients receiving MDR-TB treatment, and optimal models of patient support and care. The guidelines are to be used primarily in national TB programmes, or their equivalents in Ministries of Health, and for other policy-makers and technical organizations working on TB and infectious diseases in public and private sectors and in the community.
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 extensively drug-resistant tuberculosis. Resolution WHA62.15, adopted in 2009, calls on Member States to develop a comprehensive framework for the management and care of patients with drug-resistant TB. The recommendations contained in these guidelines address the most topical questions concerning the programmatic management of drug-resistant TB: case-finding, multidrug resistance, treatment regimens, monitoring the response to treatment, and selecting models of care. The guidelines primarily target staff and medical practitioners working in TB treatment and control, and partners and organizations providing technical and financial support for care of drug-resistant TB in settings where resources are limited.
With the growing breadth and complexity of TB efforts today comes a greater range of concerns associated with the ethics of action, inaction and specific approaches to clinical, public health and research interventions. In 2006, the documented emergence of extensively drug-resistant tuberculosis (XDR-TB),2 including a dramatic and lethal outbreak in South Africa, brought forward urgent issues of public health ethics given the imposition in some programs of involuntary detention of persons suspected and/or confirmed of being ill with drug-resistant TB under the justification of public safety. In a linked effort, the Stop TB Partnership agreed to establish a TB and Human Rights Task Force in 2010, with secretariat being provided by WHO and the Joint United Nations Program on HIV/AIDS (UNAIDS). The Task Force will aim to develop a policy framework for a rights-based approach to TB prevention, care and control as joint products of WHO, the Stop TB Partnership and UNAIDS. It will also propose a strategic agenda for action. It will be composed of major stakeholders, constituencies from affected communities and risk groups, human rights and civil society organizations, health and human rights experts, United Nations agencies, and development partners. This ethics guidance and the resulting rights-based policy framework will be used as complementary and companion documents to guide further dialogue and action in these areas.
The main purpose of these recommendations is to assist national and local public health tuberculosis (TB) control programmes in low- and middle-income countries to develop and implement case finding among people exposed to infectious cases of TB. Systematic evaluation of people who have been exposed to potentially infectious cases of tuberculosis (TB) can be an efficient, targeted approach to intensified TB case finding that is within the purview of TB control programmes. There are, however, no comprehensive global recommendations for programmes. WHO, the International Union against Tuberculosis and Lung Disease and the International Standards for Tuberculosis Care all recommend that children under 5 years of age and persons living with HIV (PLHIV) who are exposed to infectious cases of TB be evaluated for active TB and considered for treatment of latent tuberculosis infection (LTBI) if active TB is excluded. With these exceptions, there are no recommendations at global level to: 1. define the epidemiological and programme conditions under which contact investigation is indicated;2. describe TB index patients on whom contact investigation should be focused;3. identify TB contacts who should be investigated (other than children under 5 years of age and PLHIV);and recommend the procedures to be used for identifying, screening and tracking TB contacts. The following recommendations are based on recent systematic reviews of the literature on contact investigation in low- and middle-income countries.
This Open Access volume provides in-depth analysis of the wide range of ethical issues associated with drug-resistant infectious diseases. Antimicrobial resistance (AMR) is widely recognized to be one of the greatest threats to global public health in coming decades; and it has thus become a major topic of discussion among leading bioethicists and scholars from related disciplines including economics, epidemiology, law, and political theory. Topics covered in this volume include responsible use of antimicrobials; control of multi-resistant hospital-acquired infections; privacy and data collection; antibiotic use in childhood and at the end of life; agricultural and veterinary sources of resistance; resistant HIV, tuberculosis, and malaria; mandatory treatment; and trade-offs between current and future generations. As the first book focused on ethical issues associated with drug resistance, it makes a timely contribution to debates regarding practice and policy that are of crucial importance to global public health in the 21st century.