Framework Program in Global Health:
Grant Recipient

Janine Knudsen
Use of Drug-Susceptibility Testing in the Retreatment of Moroccan Patients with Pulmonary Tuberculosis (TB) Who Fail Initial TB Treatment  
Fall 2008

Country: Morocco

Advisor: Jonathan Golub

Program: BS at the Zanvyl Krieger School of Arts & Sciences, with concentrations in Public Health, Anthropology, and Pre-Med

Project Abstract:
A major roadblock to the success of Morocco’s National Treatment Program (NTP) for Tuberculosis (TB), which follows the guidelines of the WHO Directly Observed Therapy (DOTS) Program, is the re-treatment of failed tuberculosis (TB) treatment cases.  In Morocco “failure” cases, which are defined by the WHO as patients who exhibit persistent infection despite 5 to 6 months of treatment, have a much lower success rate upon retreatment and have been associated with drug-resistant strains.  Morocco’s NTP recommends routine drug susceptibility testing (DST) prior to retreatment since the test is essential to the surveillance and treatment of Drug Resistant (DR)-TB and Multi Drug Resistant (MDR)-TB.  The frequency of DST in Morocco has not yet been determined.  Furthermore, failure cases may receive inappropriate treatment according to existing WHO guidelines.