The paradigm shift to end tuberculosis. Are we ready to assume the changes?

Abstract

Tuberculosis (TB) is the number one infectious disease killer and exemplifies the most neglected of them. Drug-susceptible TB presents with high mortality especially in atypical forms, disproportionally affecting immunosuppressed and vulnerable populations. The drug-resistant TB (DR-TB) epidemic, a world crisis, is sustained and increased through person-to-person transmission in households and the community. TB diagnostics and treatment in recent years are highly evolving fields. New rapid molecular tests are changing the perspectives in diagnosis and resistance screening. Also, new drugs and shorter regimens for DR-TB are appearing. For the first time in recent history, a large number of randomized control trials are incoming. Areas covered: This article reviews most TB advances including new diagnostic tests, drugs, and regimens and outlines upcoming drug trials while disclosing the potential gaps the in development of patient-centered systems and current organizational challenges leading to a delay in the uptake of these innovations. Expert commentary: Innovations are occurring, but not many are implemented on a wide scale in developing countries. TB health systems and staff are not getting updated in parallel. More efforts and funds are needed not only to implement current novelties but also to research for future solutions to eliminate TB.

Representations on adherence to the treatment of Multidrug-Resistant Tuberculosis

“…With the advent of chemotherapy and advances in diagnostics, it was believed that tuberculosis (TB) would be easily controlled. However, it continues to present relevance as a public health problem despite the possibility of being cured through appropriate treatment (1) .…”

An Epidemic of Drug Resistance: Tuberculosis in the Twenty-First Century

“…Whereas these contributions have called for the inclusion of social science knowledge and life science know-how, they have yet to challenge the separation of these knowledge domains in the first place. Others see the paradigm shift mainly in the form of rolling out therapeutic and technological innovations more effectively while lamenting that most high-burden countries fail to do so [ 40 ] without much reflection on why this is the case.…”

Situational analysis of 10 countries with a high burden of drug-resistant tuberculosis 2 years post-UNHLM declaration: progress and setbacks in a changing landscape

“…DR-TB could reverse the progress made against TB, especially in low-and middle-income countries due to the gap in access to quality diagnosis, prevention, treatment and care. Some challenges could be overcome with the advent of innovative technologies (Monedero et al, 2017), stronger partnerships and firm political commitments, all notable in the last 10 years. Annual targets aligned with WHO's End TB Strategy (Stop TB Partnership, 2019) were assigned to countries to monitor progress in their capacity to diagnose and treat DR-TB.…”