Padayatchi N, Friedland G
Centre for the AIDS Programme of Research in South Africa (CAPRISA), University of KwaZulu-Natal, Durban, South Africa.
Int J Tuberc Lung Dis. 2008 Aug;12(8):978-80.
A growing number of cases of extensively drug-resistant tuberculosis (XDR-TB) have been reported from KwaZulu-Natal, South Africa.
To propose an alternative model to centralised care that can be implemented to alleviate the current emergency.
The current failing TB programme could be improved by borrowing strategies such as decentralisation of care, treatment expertise, high levels of treatment adherence and successful outcomes, all of which have been successfully implemented in the human immunodeficiency virus programme. Patients with multidrug-resistant or XDR-TB could be admitted to institutions closer to their homes for treatment with subsequent discharge to home-based care.
The longer we support a failed system or wait for a perfect solution, the more the current devastation will continue to grow.
南非夸祖鲁-纳塔尔省报告了越来越多的广泛耐药结核病（XDR-TB）病例。
提出一种可替代集中护理的模式，以缓解当前的紧急情况。
当前失败的结核病防治计划可以通过借鉴诸如护理去中心化、治疗专业知识、高治疗依从性和成功治疗结果等策略来改进，所有这些策略都已在人类免疫缺陷病毒防治计划中成功实施。耐多药或广泛耐药结核病患者可入住离家较近的机构接受治疗，随后出院接受居家护理。
我们对失败系统的支持时间越长，或者等待完美解决方案的时间越长，当前的破坏就会继续加剧。
