MDR/XDR-TB management of patients and contacts: Challenges facing the new decade. The 2020 clinical update by the Global Tuberculosis Network.
Migliori, Giovanni Battista;
Tiberi, Simon;
Zumla, Alimuddin;
Petersen, Eskild;
Chakaya, Jeremiah Muhwa;
Wejse, Christian;
Muñoz Torrico, Marcela;
Duarte, Raquel;
Alffenaar, Jan Willem;
Schaaf, H Simon;
+14 more...Marais, Ben J;
Cirillo, Daniela Maria;
Alagna, Riccardo;
Rendon, Adrian;
Pontali, Emanuele;
Piubello, Alberto;
Figueroa, José;
Ferlazzo, Gabriella;
García-Basteiro, Alberto;
Centis, Rosella;
Visca, Dina;
D'Ambrosio, Lia;
Sotgiu, Giovanni;
members of the Global Tuberculosis Network;
Global Tuberculosis Network;
(2020)
MDR/XDR-TB management of patients and contacts: Challenges facing the new decade. The 2020 clinical update by the Global Tuberculosis Network.
International journal of infectious diseases : IJID : official publication of the International Society for Infectious Diseases, 92S.
S15-S25.
ISSN 1201-9712
DOI: https://doi.org/10.1016/j.ijid.2020.01.042
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The continuous flow of new research articles on MDR-TB diagnosis, treatment, prevention and rehabilitation requires frequent update of existing guidelines. This review is aimed at providing clinicians and public health staff with an updated and easy-to-consult document arising from consensus of Global Tuberculosis Network (GTN) experts. The core published documents and guidelines have been reviewed, including the recently published MDR-TB WHO rapid advice and ATS/CDC/ERS/IDSA guidelines. After a rapid review of epidemiology and risk factors, the clinical priorities on MDR-TB diagnosis (including whole genome sequencing and drug-susceptibility testing interpretations) and treatment (treatment design and management, TB in children) are discussed. Furthermore, the review comprehensively describes the latest information on contact tracing and LTBI management in MDR-TB contacts, while providing guidance on post-treatment functional evaluation and rehabilitation of TB sequelae, infection control and other public health priorities.
