Situational analysis of 10 countries with a high burden of drug-resistant tuberculosis 2 years post-UNHLM declaration: progress and setbacks in a changing landscape

International Journal of Infectious Diseases

Douglas Fraser Wares¹  Medea Gegia²  Fuad Mirzayev³  Sarabjit S. Chadha⁴  Ignacio Monedero-Recuero⁵ 

[1] Corresponding author at: International Union against Tuberculosis and Lung Disease, 68, boulevard Saint-Michel, F-75006 Paris, France.;TB-HIV Department, International Union against Tuberculosis and Lung Disease, Paris, France;KNCV Tuberculosis Foundation, The Hague, The Netherlands;Prevention, Diagnosis, Treatment, Care and Innovation Unit, Global TB Programme, World Health Organization, Geneva, Switzerland;Unitat d'Atenció Territorial a la Cronicitat i Complexitat Garraf, Institut Català de la Salut, Departament de Salut, Generalitat de Catalunya, Barcelona, Spain;

关键词: Tuberculosis;    UNHLM;    DR-TB;    Multi-drug-resistant tuberculosis;    High-burden countries;    COVID-19;   

DOI  :  

来源: DOAJ

【 摘 要 】

Objectives: Globally, drug-resistant tuberculosis (DR-TB) is the leading cause of death globally related to antimicrobial resistance, affecting 500,000 emergent cases annually. In 2018, the first United Nations High-Level Meeting (UNHLM) on tuberculosis declared DR-TB a global public health priority. Bold country targets were established for 2018–2022. This study reviews the DR-TB situation in 2018, and the UNHLM target accomplishments in 10 high-burden countries (HBCs). Methods: An ecological descriptive analysis of the top 10 DR-TB HBCs (Bangladesh, China, India, Indonesia, Myanmar, Nigeria, Pakistan, Philippines, Russian Federation, and South Africa), which share 70% of the global DR-TB burden, was undertaken, complemented by a cascade-of-care analysis and a survey gathering additional information on key advances and setbacks 2 years after the UNHLM declaration. Results: Most countries are showing historic advances and are on track for the 2018 and 2019 targets. However, according to the cascade-of-care, none of the countries are capable of providing effective care for 50% of the estimated patients. Increasing levels of fluoroquinolone resistance and access to timely susceptibility testing can jeopardize ongoing adoption of shorter, all-oral treatment regimens. The programmatic management of DR-TB in children remains minimal. Achievements for 2020 and beyond may be affected significantly by the coronavirus disease 2019 (COVID-19) pandemic. Conclusion: Triggered by the COVID-19 pandemic, there is a global risk of recoil in DR-TB care with long-term consequences in terms of deaths, suffering and wider transmission. Investment to support DR-TB services is more important now than ever to meet the aspirations of the UNHLM declaration.

【 授权许可】

Unknown