Programmatic management of multi-drug resistant tuberculosis

The World Health Organization's South-East Asia (SEA) Region has the highest burden of tuberculosis in the world. Appreciable progress has been made with TB control using the DOTS strategy, and several countries in the Region have reached the global targets. Renewed emphasis has been placed on reaching universal case detection and treatment of all forms of TB through improving diagnosis and management of all forms and, in particular, better managing multi- and extensively drug-resistant tuberculosis, as well as HIV-associated TB. The specific objectives of this meeting were to review progress and constraints in implementing the Stop TB strategy in Member States of the SEA Region; and provide guidance on adopting and applying the revised WHO policies and guidelines to more comprehensively address TB control in the specific context of Member States of the Region. The overall recommendations for WHO and technical partners were to collaborate with countries to improve the estimates for the TB burdens in the countries; gather evidence that can guide countries in more accurately defining case suspects based on symptoms other than cough (>2 weeks) in order to improve case detection; evaluate the performance of diagnostic algorithms in the context of smear-negative EPTB and childhood TB, and consider appropriate revisions; assist countries in deploying new tools, developing operational research on new diagnostic tools, and elaborating guidelines on the basis of the outcomes.