One in four patients newly diagnosed with tuberculosis (TB) in Kyrgyzstan has a multidrug-resistant strain of the disease.
This means they do not respond to standard first-line drugs and need longer, more complex and more intensive treatment. In addition, medical services for TB have been centralised and are largely focused on treatment in hospitals only. Consequently people have difficulty accessing medical care, particularly in rural areas.
Médecins Sans Frontières (MSF) is the only international organisation actively engaged in the direct clinical implementation of drug-resistant TB (DR-TB) programmes in Kyrgyzstan. In Kara-Suu district, Osh province, where TB rates are among the highest in the country, MSF focuses on outpatient care to limit the amount of time a patient spends in hospital and to improve their adherence to treatment. The programme aims to influence health policy and has succeeded in introducing this decentralised approach to DR-TB treatment as a key strategy for the Kyrgyzstan Ministry of Health in the coming years.
For patients with severe TB, MSF continued to diagnose and treat patients in Kara-Suu hospital, which has 80 beds, including an isolation ward for those with multidrug-resistant TB (MDR-TB). MSF provides support in the pharmacy and laboratory, and also assists with the management of the hospital’s waste, water and infection control.
Many patients have received prior treatment for TB, and more than two-thirds of them have developed drug resistance because treatment has been interrupted or they have had difficulty in adhering to it. As part of its comprehensive package of care, MSF provides psychosocial support to help people sustain and complete their arduous drug regimens.
Prison project handover
In 2006, MSF began to develop a programme providing TB diagnosis and treatment for inmates at a prison in Bishkek due to the high prevalence of the disease. The project was handed over to the International Committee of the Red Cross, the health ministry and prison authorities in 2014. MSF had enrolled and treated more than 3,000 patients over the eight years.
No. staff in 2014: 108 | Expenditure: €2.1 million | Year MSF first worked in the country: 2005 | msf.org/kyrgyzstan
Shakir – suffering from MDR-TB
While on treatment, I had no idea that I would need psychological help. But when you take the drugs, you get side effects. I became nervous and apathetic. The psychosocial support that I received from MSF during my entire treatment was tremendously helpful. After six months of outpatient treatment, the doctor came to my house with the results of my last sputum tests: "Shakirake, I have good news for you, the test results are great. You have been cured!"