Key bottlenecks in M/XDR-TB control and patient care
Providing M/XDR-TB management and care
This paper reflects the complexity of the steps needed to manage, that is diagnose, treat and care for, people with MDR-TB. The paper is not prescriptive but lays out the issues that need to be considered to facilitate decision-making on the best mix of sites to care for patients, whether in hospital or in the community. The ethical dimension of provision of care is addressed because in managing MDR-TB it is imperative to ensure that the rights and duties of patients are assured as well as those of the community. Collaboration in delivery of care for MDR-TB is recommended with all non-governmental structures, including the private sector. HIV is a major problem for people with MDR-TB, and the collaborative engagement of AIDS control programmes with their TB counterparts, in the problem of MDR-TB, is essential.