WHO strategies for the programmatic management of drug-resistant tuberculosis.
Adequate management of drug-resistant tuberculosis (TB), including multidrug- (MDR) and extensively drug-resistant (XDR-) TB are within the priorities of the newly launched World Health Organization's End TB and Elimination Strategies.



This manuscript presents the evidence on the MDR- /XDR-TB epidemiology and discusses how the five recommended priority actions can be applied at the programmatic level to tackle the epidemic: 1) prevent development of MDR-TB thorough high quality treatment of drug- susceptible TB; 2) expand rapid testing and detection of drug-resistant TB; 3) provide immediate access to effective treatment and proper care; 4) prevent transmission through infection control; 5) increase political commitment and financing. A non-systematic review using Pubmed was carried out in addition to additional relevant information taken from the abstracts of international scientific conferences. Expert commentary: Current and future control of MDR-TB significantly relies on the correct use of new diagnostics and new drugs from one side, and on the consistent application of the five core interventions at the programmatic level. In addition, it is mandatory to tackle the social determinants and socio-economic barriers favouring the MDR-TB, otherwise it will not be possible to reach the planned goals as well as TB Elimination.
a Clinic of Infectious and Tropical Diseases , University of Brescia and Brescia Spedali Civili General Hospital , Brescia , Italy.
Alberto
A
Matteelli
b World Health Organization Collaborating Centre for Tuberculosis and Lung Diseases , Fondazione S. Maugeri, Care and Research Institute , Tradate , Italy.
Rosella
R
Centis
b World Health Organization Collaborating Centre for Tuberculosis and Lung Diseases , Fondazione S. Maugeri, Care and Research Institute , Tradate , Italy.|c Public Health Consulting Group , Lugano , Switzerland.
Lia
L
D'Ambrosio
d Clinical Epidemiology and Medical Statistics Unit, Department of Biomedical Sciences , University of Sassari, Research, Medical Education and Professional Development Unit, AOU , Sassari , Italy.
Giovanni
G
Sotgiu
e Section of Infectious Diseases, Department of Medical and Surgical Sciences , University of Bologna , Bologna , Italy.
Marina
M
Tadolini
f Department of Infectious Diseases , Galliera Hospital , Genova , Italy.
Emanuele
E
Pontali
g Pneumology Unit , Fondazione Maugeri, IRCCS , Tradate , Italy.|h Department of Clinical and Experimental Medicine , University of Insubria , Varese , Italy.
Antonio
A
Spanevello
b World Health Organization Collaborating Centre for Tuberculosis and Lung Diseases , Fondazione S. Maugeri, Care and Research Institute , Tradate , Italy.
Giovanni Battista
GB
Migliori
D000995:Antitubercular Agents / Q000627:therapeutic use; D054908:Extensively Drug-Resistant Tuberculosis / Q000175:diagnosis* / Q000628:therapy*; D006801:Humans; D017053:Infection Control; D009169:Mycobacterium tuberculosis
D000995:Antitubercular Agents
Drug-resistant TB; End TB Strategy; TB control; XDR-TB; elimination; new drugs; prevention