耐药结核病的计划性管理进展,世卫组织东地中海地区,2018-2023年
K Bennani1, M van den Boom1, M G ElMedrek1
1WHO Regional Office for the Eastern Mediterranean Region, Cairo, Egypt.
IJTLD open
|September 20, 2024
概括
东地中海国家改善了耐药结核病管理,增加了Xpert MTB/RIF测试和治疗成功率. 建议进一步加强诊断和初级医疗整合,以获得最佳结果.
科学领域:
- 公共卫生 公共卫生
- 传染病管理 传染病管理
- 全球卫生倡议全球卫生倡议
背景情况:
- 自2012年以来,世界卫生组织 (WHO) 积极支持各国扩大耐药结核病 (PMDT) 的计划性管理.
- 该评估评估了PMDT计划中的进展情况并确定了PMDT计划中的挑战,以告知未来的建议.
研究的目的:
- 评估东地中海地区耐药结核病 (PMDT) 方案管理方面的进展和挑战.
- 为改善PMDT服务制定基于证据的建议.
主要方法:
- 进行了对区域绿灯委员会 (rGLC) 任务报告的审查.
- 分析了程序指标,以描述PMDT的进展.
主要成果:
- Xpert MTB/RIF测试显著增加,从2017年的5%增加到2022年的54%,用于初始结核病患者的测试.
- 多抗药 (MDR) /RR-TB患者的诊断和治疗增加了,诊断增加了29%,在2021-2022年治疗的确诊患者增加了84%.
- 对MDR/RR-TB的治疗成功率从2017年的64%提高到2020年的73%,14个国家到2023年实施全口服治疗方案.
结论:
- 东地中海地区的国家在PMDT方面取得了显著进展,特别是Xpert MTB/RIF利用,MDR/RR-TB诊断和治疗全口服方案,并改善了治疗成功率.
- 主要建议包括通过世卫组织认可的工具提高诊断能力,将服务分散到初级医疗保健中,并优先考虑BPaL (M) 方案,以获得最佳的患者结果.
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