Rahman Md Arifur, Sarkar Atanu
Division of Community Health and Humanities, Faculty of Medicine, Memorial University, St. John's, NL, Canada A1B 3V6.
Division of Community Health and Humanities, Faculty of Medicine, Memorial University, St. John's, NL, Canada A1B 3V6.
Indian J Tuberc. 2017 Jul;64(3):153-160. doi: 10.1016/j.ijtb.2017.03.006. Epub 2017 Apr 8.
Extensively Drug-resistant Tuberculosis (XDR-TB) has emerged as one of the most formidable challenges to the End TB Strategy that has targeted a 95% reduction in TB deaths and 90% reduction in cases by 2035. Globally, there were an estimated 55,100 new XDR-TB cases in 2015 in 117 countries. However, only one in 30 XDR-TB cases had been reported so far. Drug susceptibility test (DST) is the mainstay for diagnosing XDR-TB, but the lack of laboratory facilities in the resource-limited endemic countries limit its uses. A few new drugs including bedaquiline and delamanid, have the potential to improve the efficiency of XDR-TB treatment, but the drugs have been included in 39 countries only. The costs of XDR-TB treatment are several folds higher than that of the MDR-TB. Despite the financing from the donors, there is an urgent need to fill the current funding gap of US$ 2 billion to ensure effective treatment and robust surveillance. In the review article we have addressed current update on XDR-TB, including surveillance, diagnosis and the interventions needed to treat and limit its spread, emphasis on extensive financial support for implementing of current recommendations to meet the goals of End TB Strategy.
广泛耐药结核病（XDR-TB）已成为终结结核病战略面临的最严峻挑战之一，该战略的目标是到2035年将结核病死亡人数减少95%，病例数减少90%。全球范围内，2015年在117个国家估计有55100例新的广泛耐药结核病病例。然而，到目前为止，仅报告了每30例广泛耐药结核病病例中的1例。药敏试验（DST）是诊断广泛耐药结核病的主要方法，但资源有限的结核病流行国家缺乏实验室设施限制了其应用。包括贝达喹啉和地拉曼德在内的一些新药有可能提高广泛耐药结核病的治疗效率，但这些药物仅在39个国家被纳入使用。广泛耐药结核病的治疗成本比耐多药结核病高出数倍。尽管有捐助者提供资金，但迫切需要填补目前20亿美元的资金缺口，以确保有效治疗和有力监测。在这篇综述文章中，我们阐述了广泛耐药结核病的最新情况，包括监测、诊断以及治疗和限制其传播所需的干预措施，强调为实施当前建议以实现终结结核病战略目标提供广泛的财政支持。
