Scaling up programmatic management of drug-resistant tuberculosis: A prioritized research agenda.

Cobelens, F.G.; Heldal, E.; Kimerling, M.E.; Mitnick, C.D.; Podewils, L.J.; Ramachandran, R.; Rieder, H.L.; Weyer, K.; Zignol, M.; Working Group on MDR-TB of the Stop TB Partnership.

PLoS Medicine; 2008; 5; 1037-1042.

Summary Points:

The World Health Organization calls for massive scale-up of programmatic management of drug-resistant tuberculosis in resource-limited settings.

• Several technical and operational barriers impede the achievement of this scale-up.
• A research agenda, developed by the Stop TB Partnership, identifies the most important barriers and prioritizes the research questions to be addressed in order to overcome these barriers.
• Research priorities include: new and improved tools for drug resistance testing; clinical trials of simplified and shorter second-line treatment regimens; new and improved strategies for diagnosis of drug-resistant tuberculosis, treatment adherence, and infection control; understanding of the geographic variations in occurrence of drug resistance; and clinical trials of prophylactic treatment of contacts of patients with drug-resistant tuberculosis.

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