HIV & AIDS Treatment in Practice
Issue 203
This Tuberculosis guide has been developed jointly by Médecins Sans Frontières and Partners In Health. It aims at providing useful information to the clinicians and health staff for the comprehensive management of tuberculosis. Forms of susceptible and resistant tuberculosis, tuberculosis in child...ren, and HIV co-infection are all fully addressed.
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This Tuberculosis guide has been developed jointly by Médecins Sans Frontières and Partners In Health. It aims at providing useful information to the clinicians and health staff for the comprehensive management of tuberculosis. Forms of susceptible and resistant tuberculosis, tuberculosis in child...ren, and HIV co-infection are all fully addressed.
more
The consolidated guidelines are complemented by an operational handbook which is designed to assist with implementation of the WHO recommendations by Member States, technical partners and others who are involved in the management of patients with DR-TB. The WHO Operational Handbook on Tuberculosis, ...Module 4: Treatment - Drug-Resistant Tuberculosis Treatment provides practical guidance on how to put in place the recommendations at the scale needed to achieve national and global impact.
The document provides information on different aspects of care and support for TB patients. In particular, the handbook provides practical guidance on the implementation of the interventions that enable treatment adherence such as social support, treatment administration options, digital adherence technologies. The practical guidance also includes models of care for all TB patients, models of care for children and adolescents, integrated care for TB, HIV and comorbidities, engagement of private sector, managing of TB in health emergencies. This new practical handbook also includes two important chapters on health education and counselling, and palliative care for patients with TB.
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These guidelines group all recommendations on TB care and support in one document and are complemented by an operational handbook. The guidelines are to be used primarily by national TB programmes, or their equivalents in Ministries of Health, stakeholders and technical organizations working on... TB care in the public and private sectors and in the community.
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Se estima que unos 10 millones de personas contrajeron tuberculosis (TB) en el 2019 y que a unos 3 millones de ellas no se les diagnosticó ni se les notificó la enfermedad. Con el propósito de poner fin a la epidemia mundial de la tuberculosis para el 2030, sigue siendo necesario ampliar la capac...idad para analizar un gran número de muestras.
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El agente etiológico de la tuberculosis es el Mycobacterium tuberculosis o bacilo de Koch. Se trata de un bacilo aerobio estricto, ácido-alcohol resistente, sin movilidad, de crecimiento lento y que se inactiva con rayos ultravioleta y temperaturas mayores de 60°C.
Preventing tuberculosis infection from progressing to tuberculosis disease is a crucial component of the goal to eliminate tuberculosis. When deciding on the use of tuberculosis preventive therapy among household contacts, policy makers regularly ask questions, such as whether tuberculosis preventiv...e therapy is effective, safe, and feasible in a programme setting and what it will cost. For contact management and tuberculosis preventive therapy for multidrug-resistant and rifampicin-resistant tuberculosis, studies from high-income and low-income countries have shown feasibility, safety, and effectiveness.
However, there is scarce information on the cost of tuberculosis preventive therapy for multidrug-resistant and rifampicin-resistant tuberculosis. In The Lancet Global Health, Peter Dodd and colleagues show that household contact management strategies are cost-effective even in low-income and middle-income countries, which has important policy implications for achieving the END TB Strategy goals.
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Three classess of tests are now recommended in the latest consolidated guideles on tests for tuberculosis infection. It includes for the first-time a new class of Mycobacterium tuberculosis antigen-based skin tests (TBSTs), and the two existing classes of tests: the tuberculin skin test (TST) and t...he interferon-gamma release assays (IGRAs).
IGRAs and TBSTs use Mycobacterium tuberculosis complex specific antigens and represent a significant advancement to TST which has been used for over half a century.
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Technical information note. Ensuring an uninterrupted supply of quality-assured, affordable anti-TB
drugs and diagnostics to the world
GDF is the largest global provider of quality-assured tuberculosis (TB)
medicines, diagnostics, and laboratory supplies to the public sector.
Since 2001, GDF has facilitated access to high-quality TB care in over 130
countries, providing treatments to over 30 million people with TB and procuring
...
and delivering more than $200 million worth of diagnostic equipment
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The WHO standard: Universal access to rapid tuberculosis diagnostics sets benchmarks to achieve universal access to WHO-recommended rapid diagnostics (WRDs), increase bacteriologically confirmed tuberculosis and drug resistance detection, and reduce the time to diagnosis. WHO-recommended rapid diagn...ostics are highly accurate, cost-effective, reduce the time to treatment initiation, and impact patient-important outcomes.
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En la reunión de alto nivel de las Naciones Unidas del 2018 se fijó el objetivo de tratar al menos a 40 millones de personas con tuberculosis (TB) entre el 2018 y el 2022; sin embargo, en el 2021 ese objetivo solo se había cumplido en un 66%. Las pruebas diagnósticas son fundamentales para logra...r el objetivo, pero constituyen un eslabón débil en la continuidad de la atención. Las pruebas de diagnóstico rápido recomendadas por la Organización Mundial de la Salud (PDRO) son sumamente precisas, acortan el tiempo hasta el inicio del tratamiento, influyen en resultados importantes para el paciente y son costo-eficaces. Aunque el objetivo para el año 2025 es que todos los pacientes notificados se hagan inicialmente una PDRO, en el 2021 tan solo el 38% se hizo una PDRO como prueba inicial, y se determinó que el acceso a las pruebas diagnósticas era un problema crítico. Una de las principales consecuencias del uso insuficiente de las PDRO es la gran brecha en la detección de la farmacorresistencia. La presente Norma de la OMS: Acceso universal a las pruebas de diagnóstico rápido de la tuberculosis se basa en las directrices de la OMS y en el manual operativo conexo
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This document provides practical guidance on planning and implementing next-generation sequencing (NGS) technology for characterization of Mycobacterium tuberculosis complex (MTBC) bacteria. The aim is to detect mutations associated with drug resistance in the context of a surveillance system for tu...berculosis (TB).
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The Roadmap towards ending TB among children and adolescents, third edition builds on the 2013 and 2018 versions. The 2023 version recognizes the progress made over the past five years and outlines priorities and key actions designed to accelerate progress towards the targets elaborated during the 2...023 United Nations General Assembly High-Level Meeting on the fight against TB. Implementation of these key actions at the global, regional, national and sub-national levels is expected to find and treat more children and adolescents with tuberculosis (TB) disease or TB infection, to prevent TB, to improve treatment outcomes and prevent TB-associated disability. The 2023 Roadmap retains the strong focus on TB in children, while also emphasizing the importance of addressing TB among adolescents, and for the first time, among pregnant and post-partum women.
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Of the more than 10 million people estimated to have fallen ill with tuberculosis (TB) in 2022, just over 400 000 people developed TB resistant to rifampicin (RIF), and 1.3 million people developed TB resistant isoniazid (INH). Drug resistance must be detected rapidly and accurately to initiate appr...opriate and effective treatment.
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