MDR-TB patients get support to fight against the disease
Amanbagt, 28, lives with her family in the outskirts of Ashgabat. Amanbagt fell ill in February 2013 when after few oddly cold winter days she felt weakness and tiredness. Amanbagt did not pay attention to those symptoms for several months, hoping to get her stamina back after summer vacation. However, by September 2013, her health steadily worsened and she started coughing. At that time, her father took Amanbagt to the Centre for TB Treatment and Prophylaxis in Ashgabat. In just 2 days, Amanbagt was diagnosed with multidrug-resistant tuberculosis and was hospitalized for treatment.
- MDR-TB is caused by Mycobacteria Tuberculosis that do not respond to at least isoniazid and rifampicin, the two most effective anti-TB drugs.
- Detection of MDR-TB cases requires advanced and costly laboratory technology.
- Treatment options for MDR-TB are limited and expensive (about $2,900 per patient per course).
- The Global Fund grant amount in Turkmenistan is USD 16,3 million.
- Coverage with drug susceptibility testing increased from 27% in 2011 to 44% in 2014.
- Rapid molecular detection of MDR-TB (Xpert technology) is available in Ashgabat and all regions of the country.
- 120 TB and family doctors are trained on management of MDR-TB.
- In total 550 MDR-TB patients will be enrolled on treatment by the end of 2015.
Amanbagt is among 547 patients with drug-resistant tuberculosis put on treatment since 2013. Despite a major progress towards achieving control of tuberculosis in Turkmenistan over the past two decades, the country has faced the high proportion of multidrug-resistant tuberculosis (MDR-TB).
The treatment turned out effective for the woman. Although the full course of hospitalization is 8 months, after only 7 months of treatment for Amanbagt, the laboratory tests showed that she did not excrete tuberculosis bacteria with their sputum. This is a sign of treatment effectiveness and that a patient is not contagious for other people anymore. Such patients can continue the treatment at the primary health care facility near the home.
“My situation would have been very complicated without this free and quality treatment of drug-resistant tuberculosis provided by the national health services. It took only for 2 days to diagnose my disease and put me on the treatment,” says Amanbagt.
Amanbagt was discharged from the hospital in the beginning of April 2014. But she was not left alone. A dedicated nurse of the National Red Crescent Society took care of Amanbagt. In accordance with the UNDP-Red Crescent contract, the society takes care of patient support during ambulatory treatment of MDR-TB. Since the first day at home, a nurse visits patients and their families 2 to 3 times per week and calls in between to confirm the daily intake of the anti-tuberculosis drugs provided at the Health House. All drugs for treatment of MDR-TB are supplied by the UNDP Project.
“We feel that we are not alone with the disease and the long-lasting treatment. There is someone who is genuinely concerned about our lives,” says Amanbagt and her family to express their gratitude for the Red Crescent nurse who counsels them during the outpatient treatment.
The nurse advises about the treatment course and answers any questions that patients have. Moreover, the nurse supports patients with overcoming various daily occurrences and concerns, which might cause interruption of treatment. At the end of every month, patients receive a motivation package of rice, flour, raisin, peanut and vegetable oil for accurate intake of drugs.
Amanbagt and her family members also attended patient educational sessions organized by the National Red Crescent Society. “We are informed about what drug-resistant tuberculosis is and learn about drugs we take in and why it is important to complete the whole course of treatment. Most importantly, we know that the drug-resistant tuberculosis is curable and therefore we have the strong motivation to fight the disease.” – adds Amanbagt.
In May 2014, Amanbagt got married and recently she gave birth to a healthy son. Now near the end of 2-year treatment, Amanbagt feels well and looks forward to completing the treatment. She is able to carry on with her daily routine and enjoys playing dutar, a national musical instrument.