The World Health Organization/International Union against Tuberculosis and Lung Disease Global Project on Surveillance for Anti-Tuberculosis Drug Resistance: A model for other infectious diseases
The World Health Organization/International Union against Tuberculosis and Lung Disease Global Project on Surveillance for Anti-Tuberculosis Drug Resistance: A model for other infectious diseases
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DOI：
10.1086/430786
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发表时间：
2005-08-15
影响因子：
11.8
通讯作者：
Wright, A
中科院分区：
文献类型：
--
作者：
Aziz, MA;Wright, A
结核病仍然是一种全球流行病，三分之一的人口受到感染，活跃病例达到 900 万。在世界卫生组织 (WHO) 6 个地区，全球 40% 的痰检阳性确诊病例中，已评估了单药和多药耐药性。 2004年世界卫生组织全球抗结核药物耐药性监测项目的报告证实了早期的发现，即耐药结核病普遍存在，而且耐多药结核病的增加令人震惊。人类免疫缺陷病毒（HIV）的流行破坏了结核病的控制，而多重耐药菌株则严重危害结核病的控制，治疗方法复杂、成本更高且效果较差。高负担国家面临的挑战包括实施 DOTS 战略以及通过 DOTS-Plus 管理已发现的多重耐药性。必须加强实验室网络，同时改进监测，阐明艾滋病毒对结核病传播和个人和人群耐药性扩大的影响，以及实施私营部门的耐药性政策。需要新的诊断工具和药物来加快多重耐药菌株的早期检测和治愈。
Tuberculosis remains a global epidemic, with one-third of the population infected and 9 million active cases. Mono- and multidrug resistance in 6 World Health Organization (WHO) regions have been assessed in 40% of the global cases diagnosed by positive results of sputum testing. The 2004 report of the WHO Global Project on Anti-Tuberculosis Drug Resistance Surveillance confirms earlier findings that drug-resistant tuberculosis is ubiquitous and that multidrug-resistant tuberculosis has increased alarmingly. Control of tuberculosis, which is undermined by the human immunodeficiency virus (HIV) epidemic, is seriously jeopardized by multidrug resistant strains, for which treatment is complex, more costly, and less successful. Challenges for high-burden countries include implementation of the DOTS strategy and management of identified multidrug resistance with DOTS-Plus. Strengthening of the laboratory network in conjunction with improvement of surveillance, elucidation of the impact of HIV on transmission of tuberculosis and on amplification of resistance at individual and population levels, and implementation of private sector policies on drug resistance are imperative. New diagnostic tools and drugs are needed to expedite early detection and cure of multiresistant strains.