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Coronavirus disease has disrupted tuberculosis services globally. Data from 33 centers in 16 countries on 5 continents showed that attendance at tuberculosis centers was lower during the first 4 months of the pandemic in 2020 than for the same period in 2019. Resources are needed to ensure tuberculosis care continuity during the pandemic.

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.

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resourced countries. Meaningful and sustained improvements in RR/MDR-TB outcomes will require better person-centered care, which moves beyond merely improving our choice and delivery of regimens to empowering people affected by TB. Given the poor outcomes achieved and risk of amplifying drug resistance, a one-size fits all approach to RR/MDR-TB management is no longer an option in the current era of innovation and technology. Confronting RR/MDR-TB in resource-limited settings will require greatly increased investment in research, including operational and implementation research, and in human resources in addition to enhancing capacity to determine variability of pathogen susceptibility and developing care programs that take into account human diversity.

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