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世界卫生组织西太平洋区域六个优先国家符合世卫组织建议的耐药结核病防治进展。

Progress on diagnosis and treatment of drug-resistant tuberculosis in line with World Health Organization recommendations in six priority countries in the Western Pacific Region.

机构信息

End TB and Leprosy Unit, World Health Organization Regional Office for the Western Pacific, Manila, Philippines.

Independent consultant, Cavite, Philippines.

出版信息

Western Pac Surveill Response J. 2022 Dec 19;13(4):1-12. doi: 10.5365/wpsar.2022.13.4.972. eCollection 2022 Oct-Dec.

Abstract

BACKGROUND

Diagnosis and treatment of drug-resistant tuberculosis (DR-TB) have radically changed in accordance with recommendations from the World Health Organization (WHO) in the past decade, allowing rapid and simple diagnosis and shorter treatment duration with new and repurposed drugs.

METHODS

A descriptive analysis of the status and progress of DR-TB diagnosis and treatment in six priority countries in the Western Pacific Region was conducted using information from interviews with countries and the WHO TB database.

RESULTS

Over the past decade, the use of Xpert MTB/RIF has increased in the six priority countries, in parallel with implementation of national policies and algorithms to use Xpert MTB/RIF as an initial diagnostic test for TB and detection of rifampicin resistance. This has resulted in increases in the number of people diagnosed with multidrug-resistant or rifampicin-resistant TB (MDR/RR-TB). Shorter treatment regimens with new and repurposed drugs have also been adopted for MDR/RR-TB cases, alongside a decentralized model of care, leading to improved treatment outcomes.

DISCUSSION

The Western Pacific Region has achieved considerable progress in the diagnosis and treatment of DR-TB, in line with the evolving WHO recommendations in the past decade. The continued commitment of Member States is needed to address remaining challenges, such as the impact of the coronavirus disease pandemic, suboptimal management and health system issues.

摘要

背景

在过去十年中,世界卫生组织 (WHO) 的建议彻底改变了耐多药结核病 (DR-TB) 的诊断和治疗方法,使新的和重新定位的药物能够快速、简单地进行诊断,并缩短治疗时间。

方法

使用国家间访谈和世卫组织结核病数据库的信息,对西太平洋区域六个优先国家的 DR-TB 诊断和治疗状况和进展进行描述性分析。

结果

在过去十年中,Xpert MTB/RIF 在六个优先国家的使用有所增加,同时实施了国家政策和算法,将 Xpert MTB/RIF 用作结核病的初始诊断测试和检测利福平耐药性。这导致被诊断患有耐多药或利福平耐药性结核病 (MDR/RR-TB) 的人数增加。还为 MDR/RR-TB 病例采用了新的和重新定位的药物较短的治疗方案,以及分散的护理模式,从而改善了治疗结果。

讨论

西太平洋区域在 DR-TB 的诊断和治疗方面取得了相当大的进展,符合过去十年中世卫组织建议的演变。需要成员国继续承诺,以应对仍然存在的挑战,如冠状病毒病大流行的影响、管理不善和卫生系统问题。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/fbe1/9912284/476ffe86f986/wpsar-13-972-g001.jpg

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