Management of MDR-TB: A Field Guide. A Companion Document to Guidelines for the Programmatic Management of Drug-resistant Tuberculosis
(2009; 62 pages)


Multidrug-resistant tuberculosis (MDR-TB) and extensively drug-resistant tuberculosis (XDR-TB) increasingly occur in resource-constrained settings. In the context of a national response to MDR- and XDR-TB, health workers in TB clinics (in district hospitals and some accredited health centres) will need to diagnose MDR-TB, initiate second-line anti-TB drugs, and monitor MDRTB treatment.

Management of MDR-TB: a field guide was created to help health workers carry out these tasks. It is a job aid that medical officers and TB nurses are meant use frequently during the day for quick reference. This module is closely related to other clinical guideline modules in the Integrated Management of Adolescent and Adult Illness (IMAI) series. In particular, the approach to chronic disease management is taken from General principles of good chronic care in the IMAI series.

It is based on the Emergency Update 2008 of Guidelines for programmatic management of drug-resistant tuberculosis (WHO/HTM/TB/2008.402), and may be considered a companion document to these guidelines. It also draws on the experience of the international health NGO Partners In Health (PIH) in many countries, and the Lesotho version of this module that was adapted by the Lesotho National TB Programme. This module should be introduced to health workers in the context of a training course with a strong emphasis on TB-HIV co-management.

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