This Course is intended as an introduction to multidrug-resistant tuberculosis (MDR-TB) management, and is aimed at medical practitioners involved in the detection, management and treatment of MDR-TB patients, under the guiding principles of the World Health Organization's Stop TB Strategy. The Course aims to facilitate self-study by medical practitioners of contemporary, evidence-based standards for diagnosis and clinical management of MDR-TB in a variety of geographical, economic and social settings. The course does not include everything you need to know to manage MDR-TB, but serves a good base for understanding the issues.
Programmatic management of drug-resistant TB (PMDT) is now regarded as an essential component of the international approach to TB care, with many countries scaling up these activities. Treatment of drug-resistant TB, including MDR-TB, is complex, expensive, and requires considerable expertise and resources.
The course presupposes essential knowledge of TB transmission, pathogenesis, and the Stop TB Strategy for TB control. In order to control drug-resistant TB worldwide, WHO and its partners recommend the treatment of MDR-TB as a priority in expanded DOTS programmes using The STOP TB Strategy. In order to support countries to meet their commitments, WHO published Guidelines for the programmatic management of drug-resistant tuberculosis2011 update based on the best evidence and practice currently available. This course is based on WHO guidelines, however, MDR-TB treatment is a programmatic activity, and treatment of patients should preferably be conducted under guidance of National TB Control Programmes and should follow national guidelines.
No course fee will be charged from those who want to complete the course.
The course is accredited by The Norwegian Medical Association and The Foundation for Professional Development in Pretoria, South Africa, in post-graduate and continuing education.
Read through each module. There are questions throughout each module which serve as self assessments. These answers are not being recorded and you should review any information that you did not understand. At the end of each module there are quizzes that must be completed and submitted for continuing medical education accreditation.
On the references page at the end of each chapter, you can choose whether you want to take the quiz that belongs to that chapter or carry on with the course content. Click on the 'Q' in the top right hand corner to do the quiz, or the crossed out 'Q' if you want to skip the quiz at this stage.
You may take the quizzes as many times as you want, during or after the course, but to print a certificate for continuing medical education credits, you must achieve a score of 80 percent or above. The course also contains multiple links. Please use the references provided through these links to access more detailed information on specific topics.
All reasonable precautions have been taken by the World Medical Association and the New Jersey Medical School (NJMS) Global Tuberculosis Institute. However this course is being distributed without warranty of any kind, either express or implied. The responsibility for the interpretation and use of the material lies with the reader. In no event shall the World Medical Association and the NJMS Global Tuberculosis Institute be liable for damages arising from its use.
As research and experience with MDR-TB progress we do expect that WHO will update its guidelines. We do our best to incorporate changes into the course, however please visit the WHO web page to check for the latest versions of the guidelines. We do our best to incorporate changes into the course, however please visit the WHO web page to check for the latest versions of the guidelines.
The online course was developed by
The World Medical Association
The NJMS Global Tuberculosis Institute
The Norwegian Medical Association
•HELP Design Group
The World Medical Association gratefully acknowledges
The Lilly MDR-TB Partnership for a generous unrestricted educational grant and a tireless coordination of the humanitarian efforts in the NGO community to fight TB.
The following health care providers and other experts contributed to the review and testing of the course: Argentina - Pilheu Maria Salomé (Gobierno de la Ciudad de Buenos Aires); Belize - Antonio Coyoc (Ministry of Health); Burkina Faso - Ousseni Wendlassida Tiemtore (National TB Program); Cambodia - Khann Sokhan (National TB Programme), Rajendra Yadav (WHO); China - Li Liang (TB123), Hernán Reyes (Regional ICRC delegation); Croatia - Ivica Vučak (Special Hospital for Lung Diseases); Ethiopia - Dawit Assefa (ICAP-Columbia University), Wubaye Walelgne Dagnaw (ICAP-Columbia University); India - Dinesh Kumar Sharma (Revised National Tuberculosis Control Programme), Shiva Shrestha (PATH India TB project), Yatin N. Dholakia (The Foundation for Medical Research); Indonesia - Maria Goretti Ametembun (Internal Medicine Clinic), Yani Jane Sugiri (Saiful Anwar General Hospital); Iraq - Mohammed Siddig A. Mudawi (UNDP); Jamaica - Terry Baker (National Chest Hospital); Lesotho - Sabine Heinrich (SolidarMed), Sipho Nyathie (ICAP-Columbia University); Nepal - Kaoru Takahashi (International Organization for Migration), Krishan Puri (Bhutanese Refugee Resettlement Program USRP), Leena Bhandari (International Organization for Migration), Manupa Lama (International Organization for Migration), Rajeev Kumar Lal (International Organization for Migration); Nigeria - Olarewaju Sunday (FHI360), Oluwatosin Kuti (Global HIV/AIDS Initiative), Osman El Tayeb (National Tuberculosis And Leprosy Control Program); Pakistan - Muhammad Arif Soomro (DOTS program District Tandoallahyar), Naghman Bashir (Noor Clinic); Puerto Rico - Ada Martinez-Cruz (Health Department TB Program); Saudi Arabia - Hamdan H Al-Jahdali (King Saud University for Health Sciences); South Africa - Alasdair Reid (UNAIDS); Swaziland - Yohannes G. Ghebreyesus (University Research Council); Switzerland - Susanne Carai (WHO); The Gambia - Christopher Linda (Medical Research Council); Tunisia - Leila Slim-Saidi (Reference Laboratory, National TB Program); United Republic of Tanzania - Juma Angolwisye Mwaibako (Mbeya Medical Research Research Programme).
The following persons and organizations were involved in development of this course:
Nisha Ahamed, NJMS Global Tuberculosis Institute
Ximena Barra, HELP Design Group, web design
Nita Bellare, HELP Design Group
Miguel Bernal, HELP Design Group, graphic design
Patrizia Carlevaro, Lilly MDR-TB Partnership
Lisa Chen, Curry International Tuberculosis Center
Beth Hurley, NJMS Global Tuberculosis Institute
Alfred Lardizabal, NJMS Global Tuberculosis Institute
Maria Paola Lia, Lilly MDR-TB Partnership
Bonita T. Mangura, NJMS Global Tuberculosis Institute
Sundari Mase, Centers for Disease Control and Prevention
Eileen Napolitano, NJMS Global Tuberculosis Institute
Lee B. Reichman, NJMS Global Tuberculosis Institute
Fiona Setchell, Lilly MDR-TB Partnership
Julia Seyer, World Medical Association, for the overall management of the course