title: Isolation unit for multidrug-resistant tuberculosis patients in a low endemic country, a step towards the World Health Organization End TB Strategy.
abstract: Tuberculosis (TB) remains a threat to public health and is the second cause of death due to a single infectious agent after HIV/AIDS. The worldwide distribution of TB is heterogeneous. The incidence is decreasing in most high-income regions, but the situation remains worrying in many parts of the world. The emergence of Mycobacterium tuberculosis strains resistant to key agents used in treatment (rifampin and isoniazid) contributes to TB transmission around the world. To achieve TB elimination, both high and low endemic countries must upscale their efforts to decrease disease transmission and improve cure rates. Management of drug-resistant TB is of particular importance. In this paper, we discuss the different models of care of multidrug-resistant TB (MDR-TB), the ethical considerations and the specific constraints present in high income countries. The management model chosen by the Belgian TB specialists in accordance with public health authorities as well as building of a specific MDR/XDR-TB isolation unit are also discussed.
authors.affiliation: Infectious Diseases Department,Saint-Pierre University Hospital, Université Libre de Bruxelles,Brussels,Belgium.
authors.forename: M C
authors.initials: MC
authors.lastname: Payen
authors.affiliation: Immunodeficiency Unit,Hôpital Erasme,Brussels,Belgium.
authors.forename: J P
authors.initials: JP
authors.lastname: VAN Vooren
authors.affiliation: Department of Microbiology,LHUB-ULB, Pole Hospitalier Universitaire de Bruxelles, Université Libre de Bruxelles,Brussels,Belgium.
authors.forename: O
authors.initials: O
authors.lastname: Vandenberg
authors.affiliation: Infectious Diseases Department,Saint-Pierre University Hospital, Université Libre de Bruxelles,Brussels,Belgium.
authors.forename: N
authors.initials: N
authors.lastname: Clumeck
authors.affiliation: Infectious Diseases Department,Saint-Pierre University Hospital, Université Libre de Bruxelles,Brussels,Belgium.
authors.forename: S
authors.initials: S
authors.lastname: DE Wit
mesh_terms: D000995:Antitubercular Agents / Q000627:therapeutic use*; D001530:Belgium; D003140:Communicable Disease Control / Q000379:methods*; D054908:Extensively Drug-Resistant Tuberculosis / Q000188:drug therapy / Q000628:therapy; D009169:Mycobacterium tuberculosis / Q000187:drug effects / Q000502:physiology; D010356:Patient Isolation / Q000295:instrumentation / Q000379:methods*; D018088:Tuberculosis, Multidrug-Resistant / Q000188:drug therapy / Q000628:therapy*
chemical_list: D000995:Antitubercular Agents
keywords: Antibiotic resistance; health policy; infectious disease control; public health emerging infections