Palliative care and symptom relief for people affected by multidrug-resistant tuberculosis

E. L. Krakauer, K. Dheda, B. Kalsdorf, L. Kuksa, A. Nadkarni, N. V. Nhung, P. Selwyn, S. Shin, A. Skrahina, E. Jaramillo

Research output: Contribution to journalArticle

Abstract

The World Health Organization (WHO) defines palliative care as the prevention and relief of the physical, psychological, social and spiritual suffering of adults and children with life-threatening illnesses and psycho-social support for their families. Palliative care and symptom relief (PCSR) also addresses suffering in nonlife-threatening situations such as after cure. PCSR should never be considered a substitute for tuberculosis (TB) prevention and treatment, but should be accessible by everyone in need. PCSR can reduce suffering and improve quality of life of patients with end-stage chronic illnesses while reducing costs for health care systems and providing financial risk protection for patients' families. It also may help enable patients to adhere to long and noxious treatments and thereby reduce mortality and help protect public health. Basic PCSR can be taught easily to TB specialists as well as primary care clinicians and delivered in hospitals, clinics or patients' homes combined with infection control. For these reasons, integration of PCSR into multidrug-resistant (MDR) and extensively drug-resistant TB (XDR-TB) treatment programs is medically and morally imperative. We propose an essential package of PCSR for people with M/XDR-TB that includes a set of safe, effective and inexpensive medicines and equipment, social supports for patients and caregivers living in extreme poverty, and necessary human resources. The package aligns with WHO guidance on programmatic management of drugresistant (DR) TB and should be universally accessible by people affected by M/XDR-TB. We also describe the ethical practice of PCSR for people with M/XDR-TB and identify needed areas of research in PCSR for people with M/XDR-TB.

Original languageEnglish (US)
Pages (from-to)881-890
Number of pages10
JournalInternational Journal of Tuberculosis and Lung Disease
Volume23
Issue number8
DOIs
StatePublished - Aug 1 2019

Fingerprint

Multidrug-Resistant Tuberculosis
Palliative Care
Tuberculosis
Social Support
Extensively Drug-Resistant Tuberculosis
Poverty
Infection Control
Psychological Stress
Caregivers
Primary Health Care
Chronic Disease
Therapeutics
Public Health
Quality of Life
Psychology
Delivery of Health Care
Costs and Cost Analysis
Equipment and Supplies
Mortality

Keywords

  • Extensively drug-resistant tuberculosis
  • Human rights
  • MDR-TB
  • Palliative care
  • Primary health care

ASJC Scopus subject areas

  • Pulmonary and Respiratory Medicine
  • Infectious Diseases

Cite this

Krakauer, E. L., Dheda, K., Kalsdorf, B., Kuksa, L., Nadkarni, A., Nhung, N. V., ... Jaramillo, E. (2019). Palliative care and symptom relief for people affected by multidrug-resistant tuberculosis. International Journal of Tuberculosis and Lung Disease, 23(8), 881-890. https://doi.org/10.5588/ijtld.18.0428

Palliative care and symptom relief for people affected by multidrug-resistant tuberculosis. / Krakauer, E. L.; Dheda, K.; Kalsdorf, B.; Kuksa, L.; Nadkarni, A.; Nhung, N. V.; Selwyn, P.; Shin, S.; Skrahina, A.; Jaramillo, E.

In: International Journal of Tuberculosis and Lung Disease, Vol. 23, No. 8, 01.08.2019, p. 881-890.

Research output: Contribution to journalArticle

Krakauer, EL, Dheda, K, Kalsdorf, B, Kuksa, L, Nadkarni, A, Nhung, NV, Selwyn, P, Shin, S, Skrahina, A & Jaramillo, E 2019, 'Palliative care and symptom relief for people affected by multidrug-resistant tuberculosis', International Journal of Tuberculosis and Lung Disease, vol. 23, no. 8, pp. 881-890. https://doi.org/10.5588/ijtld.18.0428
Krakauer, E. L. ; Dheda, K. ; Kalsdorf, B. ; Kuksa, L. ; Nadkarni, A. ; Nhung, N. V. ; Selwyn, P. ; Shin, S. ; Skrahina, A. ; Jaramillo, E. / Palliative care and symptom relief for people affected by multidrug-resistant tuberculosis. In: International Journal of Tuberculosis and Lung Disease. 2019 ; Vol. 23, No. 8. pp. 881-890.
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