Tuberculosis - from diagnosing to treatment according to the European Union standards

In the article the authors presented the epidemiological data referring to tuberculosis in some countries and in Poland. Tuberculosis continues to be a priority challenge for public health. The present chemotherapy for tuberculosis is very efficacious but has the disadvantages of being lengthy and complex. The serious problems remain drug-resistant strains of Mycobacterium tuberculosis, especially multi-drug MDR-TB and extensively-drug resistant XRD-TB as well as the prevalence of HIV co-infection among tuberculosis cases. In October, 2011 the European Union Standards for Tuberculosis Care (ESTC) were finalized. This document is consistent with WHO definitions and recommendations. ESTC consists of four sections - diagnosis, treatment, HIV and comorbidities and public health, which correspond to the International Standards for Tuberculosis Care (ISTC) from 2009. In 2013, the Polish recommendations for tuberculosis were published. The authors of this paper comment on all recommendations referring to tuberculosis. Clinical symptoms of tuberculosis and some problems connected with latent tuberculosis are presented. All sputum specimens and other samples should be submitted for microscopic, culture and drug susceptibility tests. WHO recommends rapid molecular assay, which should be performed on the day of microbiological diagnosis of tuberculosis. All patients, including those with HIV infection, who have not been previously treated and without any risk factors for drug resistance, should receive isoniazid, rifampicin, pyrazinamide and ethambutol for two months and isoniazid and rifampicin for four months. Some standards are devoted to children tuberculosis. Infection evoked by Mycobacterium tuberculosis should be elicited using tuberculin skin test and/or interferon gamma release assay (IGRA test). Children under 5 years of age and patients with HIV infection should be treated for latent tuberculosis infection with isoniazid when they do not have active tuberculosis.