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Saturday 22nd October 2016

Drug-resistant TB research needed

21st July 2008

A large increase in funding for research is needed if interventions to fight drug-resistant tuberculosis are to be successful, a new study has shown.


New research is needed to equip healthcare workers with the appropriate tools to carry out MDR-TB management programmes.

Programmes to manage MDR-TB - a man-made problem caused by weak TB control measures, including the use of inadequate drugs and regimens, poor case management and allowing preventable transmission - were shown to be up to 83% effective in recent studies.

Pilot programmes were studied in five poor countries, yielding treatment success rates of 59-83%.

But several technical and operational barriers impede further scaling-up of such programmes.

A team led by Frank Cobelens, writing in the online open-access journal PLoS Medicine, said that a new research agenda had been developed by the Stop TB Partnership of global healthcare bodies, which identified the most important barriers, and prioritised research questions to be addressed next.

At the top of the list are new and improved tools for drug resistance testing, and clinical trials of simplified and shorter second-line treatment regimens.

In addition, new and improved strategies for diagnosis of drug-resistant tuberculosis, treatment adherence, and infection control were needed, as well as an understanding of the geographic variations in occurrence of drug resistance.

A further priority was clinical trials of prophylactic treatment of contacts of patients with drug-resistant tuberculosis, to target preventable transmission.

Drug susceptibility testing, alongside the development of laboratory support, also needs to be improved to give patients the correct drugs, the authors conclude.

They call for strategies to be developed that maximise treatment adherence in a sustainable way, and for further studies into the factors that affect adherence, including the role of adverse events and levels of patient support.

TB remains a significant global health problem, responsible for an estimated 1.7 million deaths per year worldwide.

Resistance to anti-tuberculosis drugs is an important threat to tuberculosis control, found in an average of 17% of cases in 127 tuberculosis treatment settings between 1994 and 2007.


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