Progress in programmatic management of drug-resistant TB, WHO Eastern Mediterranean Region, 2018-2023
BACKGROUND: Since 2012, WHO has supported countries in scaling up programmatic management of drug-resistant tuberculosis (PMDT). We assessed progress and challenges to formulate recommendations for improvement. METHODS: We reviewed the regional Green Light Committee (rGLC)mission reports and analyse...
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International Union Against Tuberculosis and Lung Disease (The Union)
2024-09-01
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| Series: | IJTLD Open |
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| author | K. Bennani M. van den Boom M.G. ElMedrek Y. Hutin |
| author_facet | K. Bennani M. van den Boom M.G. ElMedrek Y. Hutin |
| author_sort | K. Bennani |
| collection | DOAJ |
| description | BACKGROUND: Since 2012, WHO has supported countries in scaling up programmatic management of drug-resistant tuberculosis (PMDT). We assessed progress and challenges to formulate recommendations for improvement. METHODS: We reviewed the regional Green Light Committee (rGLC)mission reports and analysed data to describe the progression of programme indicators. RESULTS: The proportion of TB patients initially tested using Xpert MTB/RIF rose from 5% in 2017 to 54% in 2022. Testing for rifampicin-resistant TB (RR-TB) increased from 4% in 2015 to 68% in 2022 among new patients and from 17% in 2015 to 94% in 2022 among those previously treated. Consequently, in 2021–2022, the number of multidrug-resistant (MDR)/RR-TB patients diagnosed increased by 29% and 84% of them were treated, accounting for 22% of estimated cases. By 2023, fourteen countries had implemented all-oral regimens, with three initiating the 6-month bedaquiline, pretomanid, linezolid, and moxifloxacin regimen (BPaL(M)). MDR/RR-TB treatment success increased from 64% in 2017 to 73% in 2020. CONCLUSIONS: Eastern Mediterranean Region countries progressed in PMDT using Xpert MTB/RIF, increased diagnosis and treatment of MDR/RR-TB patients using all-oral regimens, and improved treatment success. They must now enhance diagnostic capacity using WHO-recommended diagnostics, decentralise services while integrating them into primary health care, and prioritise the BPaL(M) regimen. |
| format | Article |
| id | doaj-art-27bd35f5a2534ab69b25a009e1b10f6e |
| institution | Kabale University |
| issn | 3005-7590 |
| language | English |
| publishDate | 2024-09-01 |
| publisher | International Union Against Tuberculosis and Lung Disease (The Union) |
| record_format | Article |
| series | IJTLD Open |
| spelling | doaj-art-27bd35f5a2534ab69b25a009e1b10f6e2025-01-22T12:16:08ZengInternational Union Against Tuberculosis and Lung Disease (The Union)IJTLD Open3005-75902024-09-011939840310.5588/ijtldopen.24.03484Progress in programmatic management of drug-resistant TB, WHO Eastern Mediterranean Region, 2018-2023K. BennaniM. van den BoomM.G. ElMedrekY. HutinBACKGROUND: Since 2012, WHO has supported countries in scaling up programmatic management of drug-resistant tuberculosis (PMDT). We assessed progress and challenges to formulate recommendations for improvement. METHODS: We reviewed the regional Green Light Committee (rGLC)mission reports and analysed data to describe the progression of programme indicators. RESULTS: The proportion of TB patients initially tested using Xpert MTB/RIF rose from 5% in 2017 to 54% in 2022. Testing for rifampicin-resistant TB (RR-TB) increased from 4% in 2015 to 68% in 2022 among new patients and from 17% in 2015 to 94% in 2022 among those previously treated. Consequently, in 2021–2022, the number of multidrug-resistant (MDR)/RR-TB patients diagnosed increased by 29% and 84% of them were treated, accounting for 22% of estimated cases. By 2023, fourteen countries had implemented all-oral regimens, with three initiating the 6-month bedaquiline, pretomanid, linezolid, and moxifloxacin regimen (BPaL(M)). MDR/RR-TB treatment success increased from 64% in 2017 to 73% in 2020. CONCLUSIONS: Eastern Mediterranean Region countries progressed in PMDT using Xpert MTB/RIF, increased diagnosis and treatment of MDR/RR-TB patients using all-oral regimens, and improved treatment success. They must now enhance diagnostic capacity using WHO-recommended diagnostics, decentralise services while integrating them into primary health care, and prioritise the BPaL(M) regimen.https://www.ingentaconnect.com/contentone/iuatld/ijtldo/2024/00000001/00000009/art00004dr-tbmdr-tbprogrammatic managementwho emr |
| spellingShingle | K. Bennani M. van den Boom M.G. ElMedrek Y. Hutin Progress in programmatic management of drug-resistant TB, WHO Eastern Mediterranean Region, 2018-2023 IJTLD Open dr-tb mdr-tb programmatic management who emr |
| title | Progress in programmatic management of drug-resistant TB, WHO Eastern Mediterranean Region, 2018-2023 |
| title_full | Progress in programmatic management of drug-resistant TB, WHO Eastern Mediterranean Region, 2018-2023 |
| title_fullStr | Progress in programmatic management of drug-resistant TB, WHO Eastern Mediterranean Region, 2018-2023 |
| title_full_unstemmed | Progress in programmatic management of drug-resistant TB, WHO Eastern Mediterranean Region, 2018-2023 |
| title_short | Progress in programmatic management of drug-resistant TB, WHO Eastern Mediterranean Region, 2018-2023 |
| title_sort | progress in programmatic management of drug resistant tb who eastern mediterranean region 2018 2023 |
| topic | dr-tb mdr-tb programmatic management who emr |
| url | https://www.ingentaconnect.com/contentone/iuatld/ijtldo/2024/00000001/00000009/art00004 |
| work_keys_str_mv | AT kbennani progressinprogrammaticmanagementofdrugresistanttbwhoeasternmediterraneanregion20182023 AT mvandenboom progressinprogrammaticmanagementofdrugresistanttbwhoeasternmediterraneanregion20182023 AT mgelmedrek progressinprogrammaticmanagementofdrugresistanttbwhoeasternmediterraneanregion20182023 AT yhutin progressinprogrammaticmanagementofdrugresistanttbwhoeasternmediterraneanregion20182023 |