The treatment of multidrug-resistant tuberculosis (MDR-TB) takes about 20 months, provided that the patient does not deviate from the prescribed course of treatment. The detection of MDR-TB can take several months, as it is necessary to prescribe standard treatment for TB and determine if the patient responds to it. In addition, special equipment for lab tests is required and its availability is one of the important factors in the rate of detection of MDR-TB.
In this regard, the UNDP project on the diagnosis and treatment of TB in Turkmenistan, funded by the Global Fund to Fight AIDS, Tuberculosis and Malaria, supports the implementation of the National TB program and provides modern equipment for the detection and treatment of MDR-TB. Bactec MGIT technology is used for the cultural diagnosis of tuberculosis and for determining drug susceptibility to TB drugs. Earlier, laboratories of the Ahal and Balkan regions sent specimens for testing to the National Reference Laboratory in Ashgabat.
“For the timely diagnosis of MDR-TB in Turkmenistan, our project has supplied and installed Bactec MGIT equipment in the Ahal and Balkan provinces. This equipment will allow laboratory specialists in Ahal and Balkan provinces to independently conduct cultural studies on liquid media for the diagnosis and monitoring of MDR-TB treatment,” said Svetlana Tomasova, laboratory specialist at the project.
The introduction of the system into the laboratory practice provides a number of significant advantages: it reduces the time for detection of mycobacteria on average to 10-20 days, and the time for determining drug sensitivity to 5 to 14 days compared to testing on dense Löwenstein–Jensen medium, where the time for obtaining results ranges from 4 to 6 weeks. The system is fully automated, safe and has the capacity to do up to 2,700 analyzes per year.
“The drug susceptibility testing is of great importance for the proper treatment of TB patients. For the treatment of tuberculosis, a medication regimen is usually prescribed. It is important that the prescribed TB medicines have a sufficiently high activity against TB mycobacterium. Therefore, it is very important to determine which antibiotics will affect the TB mycobacterium for each individual patient. Such testing is carried out before the start of treatment, as well as during the course of treatment, because if the patient takes medication with a break, or has not completed the full course of treatment, then mycobacteria in his body will become insensitive to the prescribed drugs,” explains Svetlana Tomasova.
Ahal and the Balkan remained the only regions where it was not possible to carry out the cultural method of sputum testing in regional TB laboratories. In other regions, such equipment was installed in 2014-2015. As a result, by 2019, all regions of the country are equipped with the automated BACTEC MGIT system, which will allow a full range of drug susceptibility testing, TB diagnosis, monitoring and treatment of TB patients.