Team approach to manage difficult-to-treat TB cases: Experiences in Europe and beyond

被引：22

作者：

D'Ambrosio, L. ^{[1
,2
]}

Bothamley, G. ^{[3
]}

Caminero Luna, J. A. ^{[4
,5
]}

Duarte, R. ^{[6
]}

Guglielmetti, L. ^{[7
,8
]}

Munoz Torrico, M. ^{[9
]}

Payen, M. C. ^{[10
]}

Saavedra Herrera, N. ^{[11
]}

Salazar Lezama, M. A. ^{[9
]}

Skrahina, A. ^{[12
]}

Tadolini, M. ^{[13
]}

Tiberi, S. ^{[14
,15
]}

Veziris, N. ^{[7
,8
]}

Migliori, G. B. ^{[1
]}

机构：

[1] WHO, Maugeri Care & Res Inst, Collaborating Ctr TB & Lung Dis, Tradate, Italy

[2] Publ Hlth Consulting Grp, Lugano, Switzerland

[3] Homerton Univ Hosp, London, England

[4] Hosp Gen Gran Canaria Dr Negrin, Pneumol Dept, Las Palmas Gran Canaria, Spain

[5] Int Union TB & Lung Dis Union, TB Div, MDR TB Unit, Paris, France

[6] Univ Porto, Hosp Ctr Vila Nova De Gaia, Natl Reference Ctr MDR TB, Fac Med,Dept Pneumol,Publ Hlth Sci & Med Educ Dep, Porto, Portugal

[7] UPMC Univ Paris 06, Sorbonne Univ, INSERM, U1135,CR7,CIMI, F-75013 Paris, France

[8] Hop Univ Est Parisien, AP HP, Ctr Natl Reference Mycobacteries & Resistance Myc, F-75013 Paris, France

[9] Natl Inst Resp Dis Mexico INER, TB Clin, Mexico City, DF, Mexico

[10] ULB, CHU St Pierre, Div Infect Dis, Brussels, Belgium

[11] Natl TB Programme, Mexico City, DF, Mexico

[12] Republican Res & Pract Ctr Pulmonol & TB, Minsk, BELARUS

[13] Alma Mater Studiorum Univ Bologna, Dept Med & Surg Sci, Unit Infect Dis, Bologna, Italy

[14] Royal London Hosp, Div Infect, Barts Hlth NHS Trust, London, England

[15] Queen Mary Univ London, Barts & London Sch Med & Dent, Blizard Inst, London E1 2AT, England

来源：

PULMONOLOGY | 2018年 / 24卷 / 02期

关键词：

MDR-TB; XDR-TB; Clinical management; Drug resistance; Prevention; Consilium; DRUG-RESISTANT TUBERCULOSIS; UNION STANDARDS; COST; ELIMINATION; CLINICIAN; SERVICE;

D O I：

10.1016/j.rppnen.2017.10.005

中图分类号：

R56 [呼吸系及胸部疾病];

学科分类号：

摘要：

As recommended by the World Health Organization (WHO), optimal management of MDR-TB cases can be ensured by a multi-speciality consultation body known as 'TB Consilium'. This body usually includes different medical specialities, competences and perspectives (e.g., clinical expertise both for adults and children; surgical, radiological and public health expertise; psychological background and nursing experience, among others), thus lowering the risk of making mistakes - or managing the patients inappropriately, in order to improve their clinical outcomes. At present, several high MDR-TB burden countries in the different WHO regions (and beyond) have introduced TB Consilium-like bodies at the national or subnational level to reach consensus on the best treatment approach for their patients affected by TB. In addition, in countries/settings where a formal system of consultation does not exist, specialized staff from MDR-TB reference centres or international organizations usually spend a considerable amount of their working time responding to phone or e-mail clinical queries on how to manage M/XDR-TB cases. The aim of this manuscript is to describe the different experiences with the TB Consilia both at the international level (European Respiratory Society - ERS/WHO TB Consilium) and in some of the countries where this experience operates successfully in Europe and beyond. The Consilium experiences are described around the following topics: (1) history, aims and focus; (2) management and funding; (3) technical functioning and structure; (4) results achieved. In addition a comparative analysis of the TB Consilia in the different countries has been performed. (C) 2017 Sociedade Portuguesa de Pneumologia. Published by Elsevier Espana, S.L.U.

引用

页码：132 / 141

页数：10