Challenges to the global control of tuberculosis

Diagnosis and treatment of tuberculosis (TB) will likely navigate a historical turning point in the 2010s with a new management paradigm emerging. However, global control of TB remains a formidable challenge for the decades to come. The estimated case detection rate of TB globally was 66%, and there...

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Bibliographic Details
Published in:Respirology (Carlton, Vic.) Vol. 18; no. 4; pp. 596 - 604
Main Authors: Chiang, Chen-Yuan, Van Weezenbeek, Catharina, Mori, Toru, Enarson, Donald A.
Format: Journal Article
Language:English
Published: Australia Blackwell Publishing Ltd 01.05.2013
Subjects:
Cost-Benefit Analysis
Disease Management
human immunodeficiency virus
Humans
International Cooperation
multidrug resistance
Mycobacterium
Prevalence
prevention and control
treatment outcome
tuberculosis
Tuberculosis - drug therapy
Tuberculosis - epidemiology
Tuberculosis - prevention & control
World Health Organization
ISSN:1323-7799, 1440-1843, 1440-1843
Online Access:Get full text
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Summary:Diagnosis and treatment of tuberculosis (TB) will likely navigate a historical turning point in the 2010s with a new management paradigm emerging. However, global control of TB remains a formidable challenge for the decades to come. The estimated case detection rate of TB globally was 66%, and there were 310 000 estimated multidrug‐resistant TB (MDR‐TB) cases among the 6.2 million TB patients notified in 2011. Although new tools are being introduced for the diagnosis of MDR‐TB, there are operational and cost issues related to their use that require urgent attention, so that the poor and vulnerable can benefit. World Health Organization (WHO) estimated that globally, 3.7% of new cases and 20% of previously treated cases have MDR‐TB. However, the scale‐up of programmatic management of drug‐resistant TB is slow, with only 60 000 MDR‐TB cases notified to WHO in 2011. The overall proportion of treatment success of MDR‐TB notified globally in 2009 was 48%, far below the global target of 75% success rate. Although new tools and drugs have the potential to significantly improve both case detection and treatment outcome, adequate health systems and human resources are needed for rapid uptake and proper implementation to have the impact required to eliminate TB. Hence, the global TB community should broaden its scope, seek intersectoral collaboration and advocate for cost reduction of new tools, while ensuring that the basics of TB control are implemented to reduce the TB burden through the current ‘prevention through case management’ paradigm.
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ArticleID:RESP12067
ObjectType-Article-1
SourceType-Scholarly Journals-1
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ISSN:1323-7799
1440-1843
1440-1843
DOI:10.1111/resp.12067