The first patient ever treated for extensively drug-resistant tuberculosis (XDR-TB) in Tajikistan was declared cured in December.
The 17-year-old received treatment through the paediatric TB programme supported by Médecins Sans Frontières (MSF) at Dushanbe hospital. The programme provides TB diagnosis and treatment for young people aged 18 or under. Before MSF began the project, children undergoing standard TB treatment had to withstand long, isolated periods in hospital, while those with multidrug-resistant TB (MDR-TB) or XDR-TB (for whom first- and second-line antibiotics, respectively, have failed) went untreated.
Children with TB now receive appropriate treatment on an outpatient basis whenever possible, with nutritional and psychosocial support to help them adhere to their arduous regimens. In 2014, drug compounding (combining drugs to create a formulation particular to a patient’s needs) was introduced to make paediatric formulations of drugs for MDR-TB.
The health ministry, in partnership with MSF, diagnoses and treats patients’ family members and MSF searches for individual solutions for people who live far from the hospital. MSF is also working to eliminate the stigma of TB and to facilitate children’s return to school.
Until now, only MSF was providing XDR-TB treatment in Tajikistan, but discussions with the Global Fund and the United Nations Development Programme have been successful and treatment provision is beginning to expand. The Paediatric TB Protocol developed by MSF has been adopted as the national guideline.
In May, MSF completed a response to the 2013 outbreak of kala azar (visceral leishmaniasis) in Tajikistan. MSF trained health ministry professionals including doctors, nurses, epidemiologists and laboratory technicians in seven locations, and worked on national guidelines for disease management.
No. staff in 2014: 67 | Expenditure: €1.4 million | Year MSF first worked in the country: 1997 | msf.org/tajikistan