Tuberculosis 2013:5 Drug-resistant tuberculosis: time for visionary political leadership

被引：210

作者：

Abubakar, Ibrahim ^{[1
,2
]}

Zignol, Matteo ^{[3
]}

Falzon, Dennis ^{[3
]}

Raviglione, Mario ^{[3
]}

Ditiu, Lucica ^{[4
]}

Masham, Susan ^{[5
,6
]}

Adetifa, Lfedayo ^{[7
]}

Ford, Nathan ^{[8
,9
]}

Cox, Helen ^{[8
,9
]}

Lawn, Stephen D. ^{[10
]}

Marais, Ben J. ^{[11
]}

McHugh, Timothy D. ^{[12
]}

Mwaba, Peter ^{[13
,14
]}

Bates, Matthew ^{[12
,13
]}

Lipman, Marc ^{[15
]}

Zijenah, Lynn ^{[16
]}

Logan, Simon ^{[5
]}

McNerney, Ruth ^{[10
]}

Zumla, Adam ^{[13
,17
]}

Sarda, Krishna ^{[18
]}

Nahid, Payam ^{[19
]}

Hoelscher, Michael ^{[20
]}

Pletschette, Michel ^{[21
]}

Memish, Ziad A. ^{[23
,24
]}

Kim, Peter ^{[28
]}

Hafner, Richard ^{[28
]}

Cole, Stewart ^{[25
]}

Migliori, Giovanni Battista ^{[22
]}

Maeurer, Markus ^{[26
]}

Schito, Marco ^{[27
]}

Zumla, Alimuddin ^{[12
]}

机构：

[1] UCL, Dept Infect & Populat Hlth, Ctr Infect Dis Epidemiol, London NW3 2PF, England

[2] Hlth Protect Agcy, London, England

[3] WHO, Stop TB Dept, CH-1211 Geneva, Switzerland

[4] STOP TB Partnership, Geneva, Switzerland

[5] All Party Parliamentary Grp Global TB, London, England

[6] House Lords, London, England

[7] MRC, Banjul, Gambia

[8] Med Sans Frontieres, Cape Town, South Africa

[9] Univ Cape Town, Ctr Infect Dis Epidemiol & Res, ZA-7925 Cape Town, South Africa

[10] Univ London London Sch Hyg & Trop Med, Fac Infect andTrop Dis, London, England

[11] Univ Sydney, Sydney Emerging Infect & Biosecur Inst, Sydney, NSW 2006, Australia

[12] UCL, Ctr Clin Microbiol, Div Infect & Immun, London NW3 2PF, England

[13] Univ Zambia Univ Coll London Med Sch UNZA UCLMS, Res andTraining Project, Univ Teaching Hosp, Lusaka, Zambia

[14] Minist Hlth, Lusaka, Zambia

[15] UCL, Royal Free Hosp NHS Fdn Trust, Dept Resp Med, London NW3 2PF, England

[16] Univ Zimbabwe, Coll Hlth Sci, Harare, Zimbabwe

[17] Univ London, Sch Pharm, London WC1N 1AX, England

[18] India 800 Fdn, New Delhi, India

[19] Univ Calif San Francisco, Div Pulm & Crit Care, San Francisco, CA 94143 USA

[20] Klinikum Univ Munich, Dept Infect Dis & Trop Med, Munich, Germany

[21] Univ Zurich, Inst Med Microbiol, Zurich, Switzerland

[22] WHO Collaborating Ctr forTB & Lung Dis, Fdn S Maugeri, Care & Res Inst, Tradate, Italy

[23] Minist Hlth, Riyadh, Saudi Arabia

[24] Alfaisal Univ, Coll Med, Riyadh, Saudi Arabia

[25] Ecole Polytech Fed Lausanne, Global Hlth Inst, Lausanne, Switzerland

[26] Karolinska Inst, Dept Microbiol, Stockholm, Sweden

[27] NIAID, Henry M Jackson Fdn Div AIDS, NIH, Bethesda, MD 20892 USA

[28] NIAID, Div Aids, NIH, Bethesda, MD 20892 USA

来源：

LANCET INFECTIOUS DISEASES | 2013年 / 13卷 / 06期

基金：

英国惠康基金; 英国医学研究理事会;

关键词：

NEW-YORK-CITY; MYCOBACTERIUM-TUBERCULOSIS; MULTIDRUG-RESISTANCE; TREATMENT OUTCOMES; MDR-TB; INFECTION-CONTROL; EUROPEAN REGION; UNITED-STATES; RISK-FACTORS; XDR-TB;

D O I：

10.1016/S1473-3099(13)70030-6

中图分类号：

R51 [传染病];

学科分类号：

100401 ;

摘要：

Two decades ago, WHO declared tuberculosis a global emergency, and invested in the highly cost-effective directly observed treatment short-course programme to control the epidemic. At that time, most strains of Mycobacterium tuberculosis were susceptible to first-line tuberculosis drugs, and drug resistance was not a major issue. However, in 2013, tuberculosis remains a major public health concern worldwide, with prevalence of multidrug-resistant (MDR) tuberculosis rising. WHO estimates roughly 630 000 cases of MDR tuberculosis worldwide, with great variation in the frequency of MDR tuberculosis between countries. In the past 8 years, extensively drug-resistant (XDR) tuberculosis has emerged, and has been reported in 84 countries, heralding the possibility of virtually untreatable tuberculosis. Increased population movement, the continuing HIV pandemic, and the rise in MDR tuberculosis pose formidable challenges to the global control of tuberculosis. We provide an overview of the global burden of drug-resistant disease; discuss the social, health service, management, and control issues that fuel and sustain the epidemic; and suggest specific recommendations for important next steps. Visionary political leadership is needed to curb the rise of MDR and XDR tuberculosis worldwide, through sustained funding and the implementation of global and regional action plans.

引用

页码：529 / 539

页数：11

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