Operational research as a mechanism to improve treatment outcomes for drug-resistant TB in the WHO European Region
In 2022, the WHO European Region accounted for 15.1% of all incident rifampicin-resistant/multidrug-resistant TB (RR/MDR-TB) cases. Most occurred in 18 high-priority countries of eastern Europe and central Asia, many of which joined an initiative led by the WHO Regional Office for Europe. The aim wa...
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International Union Against Tuberculosis and Lung Disease (The Union)
2024-03-01
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| Series: | IJTLD Open |
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| Online Access: | https://www.ingentaconnect.com/contentone/iuatld/ijtldo/2024/00000001/00000003/art00002 |
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| author | G.B. Migliori O. Korotych J. Achar A. Ciobanu G. Dravniece M. Germanovych E. Gurbanova A. Hovhannesyan N. Khachatryan L. Kuksa N. Lomtadze M.L. Rich A. Skrahina A. Yedilbayev |
| author_facet | G.B. Migliori O. Korotych J. Achar A. Ciobanu G. Dravniece M. Germanovych E. Gurbanova A. Hovhannesyan N. Khachatryan L. Kuksa N. Lomtadze M.L. Rich A. Skrahina A. Yedilbayev |
| author_sort | G.B. Migliori |
| collection | DOAJ |
| description | In 2022, the WHO European Region accounted for 15.1% of all incident rifampicin-resistant/multidrug-resistant TB (RR/MDR-TB) cases. Most occurred in 18 high-priority countries of eastern Europe and central Asia, many of which joined an initiative led by the WHO Regional Office for Europe. The aim was to introduce three, fully oral, 9-month modified shorter treatment regimens (mSTR) to treat RR/MDR-TB under operational research conditions. The three regimens were: 1) bedaquiline + linezolid + levofloxacin + clofazimine + cycloserine (BdqLzdLfxCfzCs); 2) BdqLzdLfxCfz + delamanid (Dlm) for children over 6 years of age and adults; and 3) DlmLzdLfxCfz for children under 6 years of age. The project aimed to enhance treatment success, facilitate mSTR implementation, promote quality of care and build research capacity, while also contributing to global knowledge on all-oral mSTR use. Between April 2020 and June 2022, >2,800 patients underwent mSTR treatment in the WHO European Region. This unique experience promoted further collaboration with national tuberculosis programmes, health authorities, experts and donors within and outside Europe, with a focus on implementing operational research and improving the quality of care in high TB burden countries of the region. In the hope of encouraging others to adopt this model, we have described the principles of the initiative, its strengths and weaknesses and next steps. |
| format | Article |
| id | doaj-art-1951898b0817441a9341bba54c4e1d91 |
| institution | Kabale University |
| issn | 3005-7590 |
| language | English |
| publishDate | 2024-03-01 |
| publisher | International Union Against Tuberculosis and Lung Disease (The Union) |
| record_format | Article |
| series | IJTLD Open |
| spelling | doaj-art-1951898b0817441a9341bba54c4e1d912025-01-21T10:35:34ZengInternational Union Against Tuberculosis and Lung Disease (The Union)IJTLD Open3005-75902024-03-011310311010.5588/ijtldopen.24.00352Operational research as a mechanism to improve treatment outcomes for drug-resistant TB in the WHO European RegionG.B. Migliori0O. Korotych1J. Achar2A. Ciobanu3G. Dravniece4M. Germanovych5E. Gurbanova6A. Hovhannesyan7N. Khachatryan8L. Kuksa9N. Lomtadze10M.L. Rich11A. Skrahina12A. Yedilbayev13Servizio di Epidemiologia Clinica delle Malattie Respiratorie, Istituti Clinici Scientifici Maugeri, Istituto di Ricovero e Cura a Carattere Scientifico, Tradate, Italy;Joint Infectious Diseases Unit, World Health Organization Regional Office for Europe, Copenhagen, Denmark;Department of Global Public Health, Karolinska Institutet, Stockholm, Sweden;Joint Infectious Diseases Unit, World Health Organization Regional Office for Europe, Copenhagen, Denmark;PATH, Kyiv, Ukraine;Joint Infectious Diseases Unit, World Health Organization Regional Office for Europe, Copenhagen, Denmark;Lung Clinic, University of Tartu, Tartu, Estonia;Joint Infectious Diseases Unit, World Health Organization Regional Office for Europe, Copenhagen, Denmark;National Center of Pulmonology, Ministry of Health, Abovyan, Armenia;Tuberculosis and Lung Disease Clinic, Riga East Univesity Hospital, Riga, Latvia;National Center for Tuberculosis and Lung Diseases, Tbilisi, Georgia;Division of Global Health Equity, Brigham and Women’s Hospital, Boston, MA, USA;Republican Scientific and Practical Centre for Pulmonology and Tuberculosis, Minsk, BelarusJoint Infectious Diseases Unit, World Health Organization Regional Office for Europe, Copenhagen, Denmark;In 2022, the WHO European Region accounted for 15.1% of all incident rifampicin-resistant/multidrug-resistant TB (RR/MDR-TB) cases. Most occurred in 18 high-priority countries of eastern Europe and central Asia, many of which joined an initiative led by the WHO Regional Office for Europe. The aim was to introduce three, fully oral, 9-month modified shorter treatment regimens (mSTR) to treat RR/MDR-TB under operational research conditions. The three regimens were: 1) bedaquiline + linezolid + levofloxacin + clofazimine + cycloserine (BdqLzdLfxCfzCs); 2) BdqLzdLfxCfz + delamanid (Dlm) for children over 6 years of age and adults; and 3) DlmLzdLfxCfz for children under 6 years of age. The project aimed to enhance treatment success, facilitate mSTR implementation, promote quality of care and build research capacity, while also contributing to global knowledge on all-oral mSTR use. Between April 2020 and June 2022, >2,800 patients underwent mSTR treatment in the WHO European Region. This unique experience promoted further collaboration with national tuberculosis programmes, health authorities, experts and donors within and outside Europe, with a focus on implementing operational research and improving the quality of care in high TB burden countries of the region. In the hope of encouraging others to adopt this model, we have described the principles of the initiative, its strengths and weaknesses and next steps.https://www.ingentaconnect.com/contentone/iuatld/ijtldo/2024/00000001/00000003/art00002tuberculosismdr-tbshorter regimensrifampicin resistantmstr |
| spellingShingle | G.B. Migliori O. Korotych J. Achar A. Ciobanu G. Dravniece M. Germanovych E. Gurbanova A. Hovhannesyan N. Khachatryan L. Kuksa N. Lomtadze M.L. Rich A. Skrahina A. Yedilbayev Operational research as a mechanism to improve treatment outcomes for drug-resistant TB in the WHO European Region IJTLD Open tuberculosis mdr-tb shorter regimens rifampicin resistant mstr |
| title | Operational research as a mechanism to improve treatment outcomes for drug-resistant TB in the WHO European Region |
| title_full | Operational research as a mechanism to improve treatment outcomes for drug-resistant TB in the WHO European Region |
| title_fullStr | Operational research as a mechanism to improve treatment outcomes for drug-resistant TB in the WHO European Region |
| title_full_unstemmed | Operational research as a mechanism to improve treatment outcomes for drug-resistant TB in the WHO European Region |
| title_short | Operational research as a mechanism to improve treatment outcomes for drug-resistant TB in the WHO European Region |
| title_sort | operational research as a mechanism to improve treatment outcomes for drug resistant tb in the who european region |
| topic | tuberculosis mdr-tb shorter regimens rifampicin resistant mstr |
| url | https://www.ingentaconnect.com/contentone/iuatld/ijtldo/2024/00000001/00000003/art00002 |
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