Le retour de la tuberculose

Des générations de médecins, d’hommes politiques et de professionnels de la santé se sont battues pour vaincre la tuberculose. Mais, après des années d’accalmie, la maladie fait son grand retour. Sa résurgence dans le monde occidental, depuis 1992, était initialement attribuée au VIH. Cependant, d’autres facteurs responsables de l’augmentation du nombre de cas, tels que l’immigration et un type particulier de tuberculose pharmacorésistante, ont émergé au fil des années.

L’Organisation mondiale de la santé a élaboré une stratégie pour lutter contre la recrudescence de la tuberculose, dont une thérapie répondant à des normes adaptées en matière de médicaments, de posologie et de période de prescription. La tuberculose multirésistante (TBMR), qui regroupe toutes les formes de la maladie résistant aux thérapeutiques habituelles à base d’isionazide et de rifampicine, représente une menace sérieuse : le traitement traditionnel étant moins efficace, la transmission de la TBMR poursuit son chemin.

Lorsqu’elle n’est pas traitée correctement, la maladie devient multirésistante. L’échec du traitement fait donc partie soit de la cause, soit de la conséquence de l’apparition de cette forme de tuberculose. Il est pour l’heure nécessaire de mettre au point une thérapeutique et une stratégie plus complexes de contrôle de la maladie, afin de guérir le plus grand nombre de cas possible, d’empêcher la pharmacorésistance et d’amoindrir la transmission de l’infection. L’OMS recommande la DOTS, stratégie de traitement sous supervision directe ( Directly Observed Therapy Strategy ), et s’est fixé pour objectif de dépister au moins 70 % des cas infectieux et d’en guérir 85 %.

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