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Management and control of multidrug-resistant tuberculosis (MDR-TB): Addressing policy needs for India

Abstract

Multidrug-resistant tuberculosis (MDR-TB) challenges TB control efforts because of delays in diagnosis plus its long-term treatment which has toxic effects. Of TB high-incidence countries, India carries the highest burden of MDR-TB cases. We describe policy issues in India concerning MDR-TB diagnosis and management in a careful review of the literature including a systematic review of studies on the prevalence of MDR-TB. Of 995 articles published during 2001–2016 and retrieved from the PubMed, only 20 provided data on the population prevalence of MDR-TB. We further reviewed and describe diagnostic criteria and treatment algorithms in use and endorsed by the Revised National TB Control Program of India. We discuss problems encountered in treating MDR-TB patients with standardized regimens. Finally, we provide realistic suggestions for policymakers and program planners to improve the management and control of MDR-TB in India.

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Acknowledgements

Sachin Atre gratefully acknowledges funding support from US Department of State through the United States India Educational Foundation (USIEF) toward his one-year Fulbright-Nehru Postdoctoral fellowship at Harvard Medical School from September 2013. The authors thank Ms. Caroline McCallum for her editorial assistance.

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Atre, S., Murray, M. Management and control of multidrug-resistant tuberculosis (MDR-TB): Addressing policy needs for India. J Public Health Pol 37, 277–299 (2016). https://doi.org/10.1057/jphp.2016.14

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Keywords

  • MDR-TB
  • policy
  • India
  • pathways to care
  • primary
  • acquired