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Scaling Up Programmatic Management of Drug-Resistant Tuberculosis: A Prioritized Research Agenda

1 Aug 2008

Paul Chinnock

Source: PLoS Medicine (see original article)

Citation: Cobelens FGJ, Heldal E, Kimerling ME, Mitnick CD, Podewils LJ, et al. (2008) Scaling Up Programmatic Management of Drug-Resistant Tuberculosis: A Prioritized Research Agenda. PLoS Med 5(7): e150

2008. This is an open-access article distributed under the terms of the Creative Commons Public Domain declaration, which stipulates that, once placed in the public domain, this work may be freely reproduced, distributed, transmitted, modified, built upon, or otherwise used by anyone for any lawful purpose.

A huge increase in research will be needed before the problem of multi-drug resistant tuberculosis (MDR-TB) can be adequately addressed, according to the authors of an article in PLoS Medicine in the journal’s ‘Guidance and Guidelines’ series.

The authors describe the increases of TB cases that are resistant to both isoniazid and rifampicin as a ‘human-made’ problem. They discuss the technical and operational barriers to the massive scale-up of programmatic management of drug-resistant tuberculosis in resource-limited settings that has been called for by the World Health Organization (WHO).

Research priorities include: new and improved tools for drug resistance testing; clinical trials of simplified and shorter second-line treatment regimens; new and improved strategies for diagnosis of drug-resistant tuberculosis, treatment adherence, and infection control; understanding of the geographic variations in occurrence of drug resistance; and clinical trials of prophylactic treatment of contacts of patients with drug-resistant tuberculosis.