In response to the increasing spread of multidrug-resistant
tuberculosis (MDR-TB), the World Health Organization (WHO) has issued
new guidelines for the control of these virulent strains of the
disease. The new guidelines were released today in London at a meeting
of the world’s top MDR-TB specialists.
As the global TB pandemic continues to be a major
public health burden to the world, a new problem is threatening TB
control efforts. The epidemic of MDR-TB, defined as TB resistant to at
least isoniazid and rifampicin (the two most powerful anti-TB drugs),
has reached extraordinarily high levels in some areas and standard
drug regimens may be insufficient to contain it. To prevent the
emergence of MDR-TB, the DOTS strategy has to be followed closely. To
prevent its spread, patients with MDR-TB have to be treated
aggressively with second-line drugs.
In an attempt to address the problem of MDR-TB, WHO
and its international partners are piloting a new initiative known as
"DOTS-Plus". This initiative builds upon the foundation of
the DOTS strategy for TB control, but includes additional components,
such as the use of second-line anti-TB drugs to directly manage MDR-TB
cases. Pilot projects have been established at six sites in South
America, eastern Europe, the Russian Federation, and south-east Asia,
with plans to expand to more sites (including Africa). To assist these
projects, WHO today issued Guidelines for Establishing DOTS-Plus
Pilot Projects for the Management of MDR-TB.