National Action Plan to Combat Multidrug-Resistant Tuberculosis

• Published in: MMWR. Recommendations and reports 1992-06, Vol.41 (RR-11), p.1-48
• Main Authors: Hinman, Alan R., Hughes, James M., Berreth, Donald A., Broome, Claire V., Curran, James W., Hardy, George E., Katz, Martha F., Matthews, Gene W., Millar, J. Donald, Nicola, Ray M. (Bud), Powell, E. Kenneth, Snider, Dixie E., Warren, Rueben C., Willis, Brian M., Allen, James R., Feigal, David W., Goldberger, Mark J., Haverkos, Harry W., Hill, James C., Iser, Joseph P., McDiarmid, Melissa A., McDonald, Kenneth, Moritsugu, Kenneth P., Rosenberg, Zeda F., Ross, Alex, Shekar, Sam S., Tempest, Bruce D., Trachtenberg, Alan I., Zellinger, Jerry, Bass, John B., Callan, William J., Hadler, James L., Novick, Lloyd F., Sharma, Diane, Thacher, Arthur G.
• Format: Article
• Language: English
• Subjects: AIDS; Antituberculars; Disease transmission; Epidemiology; Health care organizations; Infections; Mycobacterium tuberculosis; Public health; Tuberculosis; Tuberculosis control
• ISSN: 1057-5987; 1545-8601

At no time in recent history has tuberculosis (TB) been as great a concern as it is today. TB cases are on the increase, and the most serious aspect of the problem is the recent occurrence of outbreaks of multidrug-resistant (MDR) TB, which pose an urgent public health problem and require rapid intervention. A Task Force composed of representatives of many federal agencies has developed a National Action Plan for addressing this problem. The Task Force identified a number of objectives to be met if MDR-TB is to be successfully combatted. These objectives fall under the categories of a) surveillance and epidemiology — determining the magnitude and nature of the problem; b) laboratory diagnosis — improving the rapidity, sensitivity, and reliability of diagnostic methods for MDR-TB; c) patient management — effectively managing patients who have MDR-TB and preventing patients with drug-susceptible TB from developing drug-resistant disease; d) screening and preventive therapy-identifying persons who are infected with or at risk of developing MDR-TB and preventing them from developing clinically active TB; e) infection control — minimizing the risk of transmission of MDR-TB to patients, workers, and others in institutional settings; f) outbreak control; g) program evaluation — ensuring that TB programs are effective in managing patients and preventing MDR-TB; h) information dissemination/training and education; and i) research to provide new, more effective tools with which to combat MDR-TB. The Action Plan lays out a series of activities to be undertaken at the national level. For each category, the Plan presents statements of problems to be overcome, followed by a summary of the objective to be achieved and steps to be carried out. For each implementation step, responsibility is assigned to the appropriate organization and start-up dates are listed.