多抗药性和广泛抗药性结核病:对全球结核病控制的威胁
Neel R Gandhi1, Paul Nunn, Keertan Dheda
1Department of Medicine, Albert Einstein College of Medicine and Montefiore Medical Center, New York, NY 10467, USA. neelgandhi@alumni.williams.edu
Lancet (London, England)
|May 22, 2010
概括
耐多药结核病 (MDR TB) 是一个日益严重的威胁,在全球范围内发现和治疗的病例很少. 紧急改善诊断,治疗和国家政策是应对这一全球健康挑战的关键.
科学领域:
- 公共卫生 公共卫生
- 传染性疾病 传染性疾病
- 全球卫生安全 全球卫生安全
背景情况:
- 全球减少药物敏感结核病的进展受到多抗药 (MDR) 和广泛抗药 (XDR) 结核病的兴起的威胁.
- 目前的应答率不足,估计MDR结核病例的低百分比在全球范围内被发现并接受治疗.
研究的目的:
- 突出各国对MDR和XDR结核病日益增长的威胁的缓慢反应.
- 强调需要提高实验室容量,感染控制和治疗计划.
- 强调国家政策和卫生系统改善对抗耐药结核病的重要性.
主要方法:
- 全球结核病发病率和治疗数据的分析.
- 对MDR和XDR结核病的现有诊断技术和药物的审查.
- 检查成功的国家一级策略的MDR结核病控制.
主要成果:
- 据估计,2008年只有7%的MDR结核病例被发现并报告给世卫组织,其中只有五分之一得到了适当的治疗.
- 对MDR和XDR结核病的治疗比对药物敏感结核病的治疗要昂贵得多,而且不那么成功.
- 一些国家表明,现有的技术可以在十年内逆转MDR结核病流行.
结论:
- 对MDR和XDR结核病的诊断和治疗进行大规模扩展至关重要,以防止耐药菌株占主导地位.
- 实验室能力,感染控制和结核病控制计划的重大改进是必要的.
- 对国家政策的承诺,卫生系统的加强和对治疗的财政可用性至关重要,特别是在负担较高的国家.
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