Atre Sachin R, Murray Megan B
Department of Global Health and Social Medicine, Harvard Medical School, Boston, MA 02115, USA.
Maharashtra Association of Anthropological Sciences, Centre for Health Research and Development (MAAS-CHRD), Pune, and Savitribai Phule Pune University, Pune, 411007, India.
J Public Health Policy. 2016 Aug;37(3):277-299. doi: 10.1057/jphp.2016.14. Epub 2016 May 6.
Multidrug-resistant tuberculosis (MDR-TB) challenges TB control efforts because of delays in diagnosis plus its long-term treatment which has toxic effects. Of TB high-incidence countries, India carries the highest burden of MDR-TB cases. We describe policy issues in India concerning MDR-TB diagnosis and management in a careful review of the literature including a systematic review of studies on the prevalence of MDR-TB. Of 995 articles published during 2001-2016 and retrieved from the PubMed, only 20 provided data on the population prevalence of MDR-TB. We further reviewed and describe diagnostic criteria and treatment algorithms in use and endorsed by the Revised National TB Control Program of India. We discuss problems encountered in treating MDR-TB patients with standardized regimens. Finally, we provide realistic suggestions for policymakers and program planners to improve the management and control of MDR-TB in India.Journal of Public Health Policy advance online publication, 6 May 2016; doi:10.1057/jphp.2016.14.
耐多药结核病（MDR-TB）给结核病防治工作带来了挑战，原因在于诊断延误以及长期治疗带来的毒性作用。在结核病高发病国家中，印度耐多药结核病例负担最重。我们通过仔细查阅文献，包括对耐多药结核病患病率研究的系统综述，阐述了印度在耐多药结核病诊断和管理方面的政策问题。从PubMed检索到的2001年至2016年发表的995篇文章中，仅有20篇提供了耐多药结核病人群患病率数据。我们进一步回顾并描述了印度修订后的国家结核病控制规划所采用和认可的诊断标准及治疗方案。我们讨论了采用标准化治疗方案治疗耐多药结核病患者时遇到的问题。最后，我们为政策制定者和项目规划者提供切实可行的建议，以改善印度耐多药结核病的管理和控制。《公共卫生政策杂志》网络预发表，2016年5月6日；doi:10.1057/jphp.2016.14
