Document Detail


Global policies and practices for managing persons exposed to multidrug-resistant tuberculosis.
MedLine Citation:
PMID:  20132616     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
SETTING: In the 1960s, treatment for latent tuberculosis infection (LTBI) with isoniazid proved to be so effective, safe, and inexpensive that research into alternative treatments virtually ceased. Now that multidrug-resistant tuberculosis (MDR-TB) is widespread, no data are available to guide the management of persons exposed to MDR-TB (contacts). METHODS: We surveyed National TB Program directors and MDR-TB program managers about current practices for managing MDR-TB contacts in countries with an MDR-TB prevalence of >2% in new patients and those with programs for managing MDR-TB. RESULTS: Of 35 countries that met the survey criteria, 25 (71%) responded; 24 of these (96%) have a guideline for managing TB contacts. Of these, 19 (76%) usually or always evaluated contacts and treated LTBI. In contrast, 10 (40%) countries reported having a guideline for managing MDR-TB contacts, 11 (44%) usually or always evaluated MDR-TB contacts, and 9 (36%) treated LTBI. Only two (8%) used a regimen that has activity against MDR-TB. Lack of evidence or guidelines was the main reason for not treating MDR-TB contacts. CONCLUSIONS: Management of MDR-TB contacts is inconsistent and ineffective due to lack of evidence-based guidelines. There is an urgent need to generate evidence to guide policy.
Authors:
K P Cain; L J Nelson; J P Cegielski
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Publication Detail:
Type:  Journal Article    
Journal Detail:
Title:  The international journal of tuberculosis and lung disease : the official journal of the International Union against Tuberculosis and Lung Disease     Volume:  14     ISSN:  1815-7920     ISO Abbreviation:  Int. J. Tuberc. Lung Dis.     Publication Date:  2010 Mar 
Date Detail:
Created Date:  2010-02-05     Completed Date:  2010-04-26     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  9706389     Medline TA:  Int J Tuberc Lung Dis     Country:  France    
Other Details:
Languages:  eng     Pagination:  269-74     Citation Subset:  IM    
Affiliation:
Division of Tuberculosis Elimination, and Epidemic Intelligence Service, Centers for Disease Control and Prevention, Atlanta, Georgia, USA. kcain@cdc.gov
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MeSH Terms
Descriptor/Qualifier:
Antitubercular Agents / pharmacology,  therapeutic use*
Contact Tracing
Data Collection
Evidence-Based Medicine / methods
Humans
National Health Programs / statistics & numerical data
Pilot Projects
Practice Guidelines as Topic*
Tuberculosis, Multidrug-Resistant / epidemiology,  prevention & control*
World Health
Chemical
Reg. No./Substance:
0/Antitubercular Agents

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine


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