Treating tuberculosis in low-resource settings: practice pragmatically

Tuberculosis (TB) remains a long-standing life-threatening contagious disease and claimed approximately 1.5 million lives worldwide in 2018.Regional variations occur extensively with polarised incidence rates between low and high TB burden countries. 1TB is a social disease in partnership with poverty.TB burden fluctuates with the rises and falls of socioeconomic development despite the advancements in healthcare. 2 Poverty-related components such as poor living conditions and malnutrition, which do not merely increase individual's susceptibility to infection, but affect healthcare expenditure and loss of income associated with TB infection amplify the effect of poverty on TB treatment and prevention.Therefore, combating TB contributes to reducing impoverishment, meanwhile fighting impoverishment assists TB control efforts especially in restricted resource settings. 3 pragmatic randomised trial conducted by Cohen et al in Malawi has evaluated a novel biosocial model to deliver effective TB in the homecare setting. 4This study assessed long-term daily injection services for the initial treatment phase of recurrent or multidrug-resistant TB (MDR-TB), with duration of receiving injectable agents ranging from 2 to 8 months.Traditionally, intramuscular injection treatment requires hospitalisation, which is costly and increases the risk of hospital-acquired infections for such prolonged treatment.