PRELIMINARY RESULTS OF THE FAMILY-DOT PROGRAM FOR PEDIATRIC PATIENTS WITH DRUG-RESISTANT TUBERCULOSIS IN THE REPUBLIC OF TAJIKISTAN
1Médecins Sans Frontières (MSF), Dushanbe, Republic of Tajikistan
2Médecins Sans Frontières (MSF), Berlin, Germany
3Republican Center for the Protection of the Population from Tuberculosis, Dushanbe, Republic of Tajikistan
4Dushanbe City Pediatric Tuberculosis Hospital, Dushanbe, Republic of Tajikistan
Objective: A description of the protocol of organizational peculiarities of cohort composition and preliminary results of the using the model of TB treatment program under the control of responsible family member Family-DOT (F-DOT) for pediatric patients with drug-resistant (DR) forms of TB (DR-TB) in the Republic of Tajikistan.
Methods: A descriptive analysis of existing MSF program data collected on eleven F-DOT patients between April 2017 and May 2018 is used.
Results: Eleven eligible patients with a stable form of tuberculosis provided the F-DOT program after receiving their prior consent. At this moment, seven of them are continuing therapy, while four of them have successfully completed the treatment. Among the participants of the program are children aged 1 to 17 years old, 54.5% of girls and 54.5% of patients with extensively drug-resistant tuberculosis (XDR TB).
Conclusions: Earlier empirical data and initial results show that there the possibility and viability is the use of models of therapy and home care for pediatric patients with DR-TB in the Republic of Tajikistan.
Keywords: Drug-resistant forms of tuberculosis, MDR-TB, XDR-TB, approaches to the therapy of children, new methods of management of tuberculosis patients, Family-DOT (F-DOT) program.
- Global tuberculosis report. WHO: Geneva; 2017. 212 p.
- Roadmap for childhood tuberculosis: towards zero deaths. WHO: Geneva; 2013. 346 p.
- Companion handbook to the WHO guidelines for the programmatic management of drug-resistant tuberculosis. WHO: Geneva; 2014. 11 p.
- Maher D, Floyd K, Sharma BV, Jaramillo E, Nkhoma W, Nyarko E. Community contribution to TB care: practice and policy review of experience of community contribution to TB care and recommendations to national TB programs. WHO: Geneva; 2003. p. 45-9.
- Benbaba S, Isaakidis P, Das M, Jadhav S, Reid, T. Direct observation (DO) for drug-resistant tuberculosis: do we really do? PLoS ONE. 2015;3:34-8. Available from: http://dx.doi.org/10.1371/journal.pone.0144936.
- Epstein RM, Street RL. The values and value of patientcentered care. Ann Fam Med. 2011;9(2):100-3. Available from: http://dx.doi.org/10.1370/afm.1239.
- Ngwatu BK, Nsengiyumva NP, Oxlade O. The impact of digital health technologies on tuberculosis treatment: a systematic review. Eur Respr J. 2018;51:1701596.
- Wright CM, Westerkamp L, Korver S, Dobler CC. Community-based directly observed therapy (DOT) versus clinic DOT for tuberculosis: a systematic review and metaanalysis of comparative effectiveness. BMC Infectious Diseases. 2015;15:210. Available from: http://dx.doi.org/10.1186/s12879-015-0945-5.
- Yin J, Yuan J, Hu Y, Wei X. Association between directly observed therapy and treatment outcomes in multidrug-resistant tuberculosis: a systematic review and metaanalysis. PLoS ONE. 2016;11(3):e0150511. Availa-ble from: http://dx.doi.org/10.1371/journal.pone.0150511.
- Mohr E, Daniels J, Beko B, Isaakidis P. DOT or SAT for Rifampicin-resistant tuberculosis? A non-randomized comparison on a high HIV-prevalence setting. PLoS ONE. 2017.12(5).e0178054.
- Mlilo N. Does the type of treatment supporter influence tuberculosis treatment outcomes in Zimbabwe? Public Health Action (PHA). 2013;3(2):146-8.
- Dave PV, Shah AN, Nimavat PB. Direct observation of treatment provided by a family member as compared to non-family member among children with new tuberculosis: a pragmatic, non-inferiority, clusterrandomized trial in Gujarat, India. PLoS ONE. 2016;11(2):e0148488. Available from: http://dx.doi.org/10.1371/journal.pone.0148488.
- Okanurak K, Kitayaporn D, Wanarangsikul W, Koompong C. Effectiveness of DOT for tuberculosis treatment outcomes: a prospect cohort study in Bangkok, Thailand. Int J Tuberc Lung Dis. 2007;11(7):762-8.
- Sis HY, Jannati A, AsghariJafarabadi M. The effectiveness of family-based DOTS versus professional mix DOTS in treating smear positive tuberculosis. Health Promotion Perspectives. 2014;4(1):98-106.
- O’Donnell MR, Daftary A, Frick M. Re-inventing adherence: toward a patientcentered model of care for drug-resistant tuberculosis and HIV. Int J Tuberc Lung Dis. 2016;20(4):430-4. Available from: http://dx.doi.org/10.5588./ijtld.15.0360.
Heike Zander, Employee of the International Organization "Médecins Sans Frontières" (Tajikistan)
Adel Springer, Employee of the International Organization "Médecins Sans Frontières" (Tajikistan)
Jarmila Klyeschikova, Medical Coordinator of the International Organization "Médecins Sans Frontières" (Tajikistan)
Sebastian Dietrich, Member of the International Organization "Médecins Sans Frontières" (Germany)
Bobodzhon Sharipov, Deputy Director of the Republican Center for the Protection of the Population from Tuberculosis
Safarali Ismoilov, Phthisiatrician, Dushanbe City Pediatric Tuberculosis Hospital
Conflict of interest: No conflict
Address for correspondence:
Medical Coordinator of the International Organization "Médecins Sans Frontières" (Tajikistan)
734025, Republic of Tajikistan, Dushanbe, Bukhoro str., 5/3
Tel.: (+992) 985 868080
Materials on the topic:
- STIGMA AND DISCRIMINATION ASSOCIATED WITH TUBERCULOSIS
- IMPROVEMENT RESULTS OF DIAGNOSIS AND TREATMENT OF ABDOMINAL TUBERCULOSIS
- ABDOMINAL TUBERCULOSIS: RETURN TO SURGERY
- DYNAMICS OF THE INDICATORS OF LUNG DESTRUCTION AND HORMONAL BACKGROUND AS A PREDICTIVE MARKER OF THE EFFECTIVENESS OF MULTIDRUG RESISTANT TUBERCULOSIS TREATMENT
- ULTRASOUND DIAGNOSTICS OF ABDOMINAL TUBERCULOSIS IN THE CONDITIONS OF THE OUTPATIENT-DIAGNOSTIC DEPARTMENT
- EFFICACY OF TUBERCULOSIS CASES DETECTION AMONG THE POPULATION OF DUSHANBE IN THE REPUBLIC OF TAJIKISTAN
- THE FREQUENCY OF DEVELOPMENT OF TUBERCULOSIS AMONG CITIZENS OF THE REPUBLIC OF TAJIKISTAN, LEAVING TO LABOR MIGRATION
- THE ROLE OF THE IMPLANTABLE PORT SYSTEM FOR THE CENTRAL VENOUS ACCESS IN TREATMENT OF PULMONARY TUBERCULOSIS WITH MULTIPLE AND EXTENSIVELY DRUG RESISTANCE (PRELIMINARY RESULTS)
- SURGICAL TREATMENT OF PULMONARY AND EXTRAPULMONARY TUBERCULOSIS
- THE INFLUENCE OF BCG VACCINATION ON THE STRUCTURE OF CLINICAL FORMS OF TUBERCULOSIS IN CHILDREN FROM THE FOCI OF INFECTION AND FROM UNSPECIFIED CONTACT FOR TUBERCULOSIS