Department of Social Medicine, Brigham and Women's Hospital, Boston, Massachusetts 02115, USA.
Int J Tuberc Lung Dis. 2011 Oct;15(10):1294-300. doi: 10.5588/ijtld.10.0591. Epub 2011 Jun 8.
Although multidrug-resistant tuberculosis (MDR-TB) is a major global health problem, there is a gap in programmatic treatment implementation.
This study describes MDR-TB treatment models in three countries--Peru, Russia and Lesotho-- using qualitative data collected over a 13-year period.
A program analysis is presented for each country focusing on baseline medical care, initial implementation and program evolution. A pattern analysis revealed six overarching themes common to all three programs: 1) importance of baseline assessments, 2) early identification of key collaborators, 3) identification of initial locus of care, 4) minimization of patient-incurred costs, 5) targeted interventions for vulnerable populations and 6) importance of technical assistance and funding. Site commonalities and differences in each of these areas were analyzed.
It is recommended that all programs providing MDR-TB treatment address these six areas during program development and implementation.
尽管耐多药结核病（MDR-TB）是一个重大的全球卫生问题，但在规划治疗实施方面存在差距。
本研究使用在过去 13 年期间收集的定性数据，描述了秘鲁、俄罗斯和莱索托三国的 MDR-TB 治疗模式。
针对每个国家，本研究提出了一个方案分析，重点关注基线医疗保健、初始实施和方案演变。模式分析揭示了所有三个方案共有的六个总体主题：1）基线评估的重要性，2）及早确定关键合作者，3）确定初始治疗地点，4）尽量减少患者的费用，5）针对弱势群体的有针对性的干预措施，6）技术援助和资金的重要性。对这些领域中的每个领域的共同性和差异性进行了分析。
建议所有提供 MDR-TB 治疗的方案在方案制定和实施过程中解决这六个方面。
