MDR-TB Treatment & Prevention
Addressing MDR TB in the context of HIV: Lessons from Lesotho
* TB Situation in Lesotho
12,275 TB new cases notified in 2007
Estimated prevalence of 544 per 100,000 population
Estimated annual incidence for all cases is 691 per 100,000 population
Estimated incidence of Sputum smear positive cases is 281 per 100,000 population
75% of new TB cases among age-group 15-44 years
Estimated all TB deaths is 107/100,000 annually
The HIV prevalence rate in Lesotho stands at 23.2% in 2005
64% of TB cases are HIV positive (WHO 2007), 80% (NTP 2008)
* Social Context of DR TB
* Barriers to Care:
Diagnosis of TB and MDR-TB in patients with HIV
Having facilities to care for very sick patients
Infection control in a high HIV setting
Having a mechanism to deliver MDR-TB care (± HIV treatment) in urban and rural areas
Shortage of trained human resource
Extreme poverty (the social and economic devastation)
Migration of workers to South Africa to work in the mines
* Facilities, Diagnosis and Drug Supplies
* Inpatient Care
* Infection Control: Masks for all staff and state-of-the-art ventilation facilities
* Occupational Policy
* Adherence to DR TB treatment
* Accompaniment/DOT
* Community-based care:
Twice-daily DOT
Injections
Psychosocial support
Screening household contacts
Accompaniment to clinical visits
Offer HTC, FP, chronic disease screening and HCG at home.
In Conclusion:
- The program trained over 200 health workers from all districts.
- We offer international training for other countries on MDR TB/HIV and infection control (3 groups from 3African countries were trained).
Note: This presentation was given at the Union/IUATLD conference in Paris last October.
Attached resource:
