[Control and management strategies in multidrug-resistant tuberculosis: literature reviewEstrategias de control y atención de la tuberculosis multirresistente: una revisión de la literatura].

objectiveTo identify control and patient management strategies for multidrug-resistant tuberculosis (MDR-TB).

methodsAn integrative review of the literature was performed through research in three health databases (LILACS, PubMed and CINAHL) and one multidisciplinary database (Scopus). Original articles published in English, Spanish or Portuguese, from 2006 to 2016, describing strategies to implement MDR-TB patient care, were included. The information collected was organized according to the strategies identified by the investigators, which were grouped into theme categories.

resultsBased on a sample of 13 articles, four categories were identified: a) DOTS-plus: reorganization of health services, improvement of local structures, standardization of professional protocols and behaviors, provision of directly observed treatment; b) service decentralization: bringing health professionals closer to patients, especially in areas with high disease burden; c) use of communication tools: software and telephone calls that allowed consultations with specialists and/or optimization of care within multiprofessional teams; d) social protection of patients: establishment of mechanisms to provide emotional, social and/or economic support to patients under treatment, strengthening adherence to drug therapy.

conclusionsSeveral strategies were identified beyond pharmacological measures, supporting the idea that the control of MDR-TB requires mechanisms that allow comprehensive care, consistent with the peculiarities and potentialities of the different scenarios where the disease occurs.