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Activities 2011
Drug-resistant tuberculosis (DR-TB) is widespread in Uzbekistan. Médecins Sans Frontières/Doctors Without Borders (MSF) is introducing a comprehensive treatment and support programme.
DR-TB
DR-TB can be transmitted from person to person just like drug-sensitive tuberculosis, but it can also develop when a TB patient, either through mismanagement or misuse of medication, becomes resistant to the standard TB drugs.
DR-TB treatment is arduous – side effects are common, and include nausea, headaches and sleep disturbances – and takes up to two years.
Understandably, it can be very difficult for patients to complete the course of treatment.
An MSF laboratory scientist carries out tests to check for tuberculosis. © Misha Friedman / MSF
Implementing comprehensive TB care
In the Autonomous Republic of Karakalpakstan, northwest Uzbekistan, MSF expanded its programme from two to five of 16 districts: Chimbay, Khodjeyli, Takhiatash town, Nukus town and Nukus region, and tripled the number of patients.
By the end of the year, some 780 patients were receiving treatment for DR-TB, and almost 200 were receiving treatment for drug-sensitive TB.
MSF’s programme includes a range of approaches, which all contribute to improving adherence. Treating people as outpatients from day one, instead of imposing a stay in hospital, can make treatment more bearable.
Educating patients about DR-TB, the medication and the side effects enables them to better understand and manage their disease. Psychological assistance, in the form of individual, group and family counselling sessions, supports patients in coping with the physical and social effects both of having TB and being on treatment.
More practical social support, such as help with transport and food, is also provided. Amid signs that Uzbekistan’s commitment to tackling TB is strengthening, MSF plans to expand its programme to three more districts in 2012.
MSF has been working in Uzbekistan since 1997.
Patient story
Rakhatay, mutidrug-resistant TB patient
“I had been treated for TB in our local hospital for over a year. There was no effect. Then I was lying at home. I guess God had pity on me, for you [MSF doctor] came to my house and told me that treatment is available. At that time I couldn’t even talk to you, I could only listen.
“It’s my daughter Kunduz, it’s thanks to her I started my treatment anew. She convinced me; she told me that I should go for this treatment.
"Now I am taking drugs. Before, I could not eat: I could only drink black tea from a spoon. I couldn’t even raise my head. Thanks to God, now I can sit and even move around.
“I never miss even one day of drugs. There are nurses – Amangul, Umyt, Muhabbat – they bring me medicines. They are all such nice people; they coax me like a child, and make up different tricks so I don’t even notice how I have swallowed the medicine.
"I am so thankful to them; I have reached such a good state of health now.”