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(2014; 420 pages)
This Companion handbook to the WHO guidelines for the programmatic management of drugresistant tuberculosis is intended to be a tool for use by national tuberculosis (TB) programme managers, clinicians and nurses, public health decision-makers and technical and implementing partners committed to the prevention, care, diagnosis and treatment of drug-resistant TB. It provides practical information on how to implement the relevant World Health Organization (WHO) policies, and provides expert opinion whenever there is, as yet, no WHO policy. Effective management of drug-resistant TB requires input from those responsible for activities related to prevention, case detection, care and treatment, surveillance, drug management, and monitoring and evaluation of a programme’s performance. The coordination of all these activities at different levels of a national TB programme are referred to as the “programmatic management of drug-resistant tuberculosis” (PMDT), and should be seen in the context of the legal and operational frameworks of local health care systems. Thus, the Handbook should be seen as an implementation guide that requires adaptation in the local context without departing from WHO’s general policy guidance.
The introduction of new diagnostic and treatment tools for the management of drug-resistant TB is making a significant contribution to enable earlier diagnosis of multidrug-resistant TB (MDR-TB), and more effective treatment in cases were therapeutic options are very limited. Yet, they do not solve many of the major challenges that continue to make the programmatic management of MDR-TB a highly complex public health intervention.
Several important new policy areas in TB care and control have been developed by WHO in recent years. These have been incorporated into this new Handbook, making it a derivative product of the 2008 and 2011 editions of the WHO Guidelines for programmatic management of drug-resistant tuberculosis, and of subsequent WHO policy guidance on diagnostics and new anti-TB drugs...