MDR-TB Treatment & Prevention

RE: [MDR-TB Treatment & Prevention] [MDR-TB Treatment & Prevention] in Afghanistan

Started by sipho maurice makhubele on 11 Sep 2011

Dear all

thank you for sharing about
Mdr Tb is very much interesting
my concern is that in some rural areas we have patient transported in the bakies
may somebody assist me how are MDR TB patient be transported

thank you
Siphosihle
Sent from my Nokia phone
-----Original Message-----
From: GHDonline (Sarder Hossain)
Sent: 11/09/2011, 14:58
To: sipho maurice makhubele
Subject: Re: [MDR-TB Treatment & Prevention] [MDR-TB Treatment & Prevention] in Afghanistan


Sarder Hossain replied to the discussion "[MDR-TB Treatment & Prevention] in Afghanistan" in the MDR-TB Treatment & Prevention community.

Reply contents:
"Dear Dr. Salem Sir,

Good to hear from you after long time.

Thank you  for your  prudent advice.
We got some patients who had treated themselves, at first, in private sector and having failed there, they get included in the treatment  facility of NTP, Afghanistan.So,most of the cases the patients are not well aware about their   initial treatment  records.
Anyway, as we discussed our today's DR-TB review panel meeting, soon,Dr haidari(our MDR-TB focal point, think you know him) will  be contacting    you along with  all the detail  findings for getting  your advices in this regards.

Kind Regards,



________________________________
Sarder Tanzir Hossain
B.Sc.(Hon's) and M.S. in Microbiology (DU)
Microbiologist, National TB Control Program,
Health Program, BRAC Afghanistan.
Website:http://www.brac.net,www.bracafg.org
 "Leader helps other people discover for themselves what they need to do"



________________________________
From: GHDonline (Salem Barghout) <>
To: Sarder Hossain <>
Sent: Sunday, 11 September 2011 4:43 PM
Subject: Re: [MDR-TB Treatment & Prevention] [MDR-TB Treatment & Prevention] in Afghanistan

Salem Barghout replied to the discussion "[MDR-TB Treatment & Prevention] in Afghanistan" in the MDR-TB Treatment & Prevention community.

Reply contents:
"Dear Sardar and All at NTP Afghanistan:

Thank you so much for sharing about this patient who, as I understand your message, seems to be resistant to H (lower concentration), R, E, Z and S (low concentration) and Ofl.  You did not specify whether this patient is a new, failure of CAT I, failure of CAT II or other categories.  Also there was no information when was the sputum collected for Culture and DST.  As you are aware of, this information would be very important to find out what drugs that the patient was on and were functionally effective throughout his previous treatment.
Anyway, to answer your question, this patient should definitely be treated as an MDR case using Am, Cs, Eto, Levofloxacin (or quality assured Moxifloxacin if available) in addition to PAS into the regimen to ensure a minimum of 4 effective or nearly effective drugs on board.  I would also add Z into the regimen (despite the fact that DST shows resistance to).  The Injectable should be used for a minimum of 8 months (with a minimum of six months after becoming culture negative) and DOT should be observed daily throughout treatmet.  Please let's know if you need any further assistance and greetings to all in Afghanistan.

Best Regards,

Salem

Salem Barghout, MD
MDR-TB Consultant
Cell: + 1 336 554 1826 (USA)
E.Mail:

       
-----Original Message-----
From: GHDonline (Sarder Hossain) [mailto:]
Sent: Sunday, September 11, 2011 6:53 AM
To: Salem Barghout
Subject: [MDR-TB Treatment & Prevention] [MDR-TB Treatment & Prevention] in Afghanistan

Sarder Hossain added a new discussion to the MDR-TB Treatment & Prevention community.

Title: [MDR-TB Treatment & Prevention] in Afghanistan

Discussion contents:
"Dear experts:
At first i am very sorry as  I unintentionally posted a new discussion topic in the place of replying to another discussion.
I need your  professional expertise on the following issues-

As we started out MDR-TB treatment in Afghanistan  only a few month back ,so we are facing some kind of  new challenges.We got one patient with its DST results performed at The Aga Khan University Hospital,karachi,Pakistan.DST results as below-
For first line drugs-

Rifampicin,Ethambutol,Isoniazid(lower concentration),Pyrazinamide and streptomycin(lower concentration) are resistant but higher concentration of isoniazid and streptomycin are sensitive.
For second line drugs-
Ofloxacin is resistant but kanamycin,amikacin,capromycin and ethionamide are sensitive.
So,may I ask you that should we start the treatment of this patient as MDR-TB under the standard MDR-TD treatment regimen or need any other special  measures?
Your kind input is highly appreciable.

Kind regards,
_______________________________
Sarder Tanzir Hossain
B.Sc.(Hon's) and M.S. in Microbiology (DU)
Microbiologist, National TB Control Program,
Health Program, BRAC Afghanistan.
Website:http://www.brac.net,www.bracafg.org
"Leader helps other people discover for themselves what they need to do"""

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