Kyrgyzstan has high rates of drug-resistant tuberculosis (DR-TB) and yet many people have difficulty accessing care, particularly in rural areas.
Initial hospitalisation of TB patients is standard practice in the country, but since starting work in Kara-Suu district in Osh province MSF has focused on providing outpatient care to limit the amount of time a patient spends in hospital. This reduces their risk of contracting an infection while in hospital, and improves their adherence to the long and arduous treatment regimen. MSF is providing comprehensive DR-TB services in Kara-Suu district, including early detection, enrolment onto the treatment programme, monthly medical consultations for patients, and social and psychological support. Teams work in three TB clinics in Kara-Suu district, providing drugs and laboratory items and mentoring Ministry of Health staff.
MSF continues to support the diagnosis and treatment of patients with DR-TB in the Kara-Suu hospital, which has a separate ward for those infected. The team also assists with the management of the hospital’s waste, and with infection control.
Teams also carry out around 20 home visits per month for patients who are unable to reach the TB clinics, providing them with their treatment as well as psychological support.
Within the framework of the endTB project, MSF is planning to introduce two new DR-TB drugs, bedaquiline and delamanid, in Kyrgyzstan in 2016. Treatment regimens will be shorter and patients will not have to endure injections.
In 2015, there were 127 DR-TB patients enrolled in MSF’s treatment programme.
No. staff in 2015: 84 | Expenditure: €2.2 million | Year MSF first worked in the country: 2005 | msf.org/kyrgyzstan
Gulmira Halmamatova – 27 years old
“In 2011, I started to feel sick and was losing weight. I was diagnosed with TB via X-ray and had to spend six months in hospital to complete my treatment. But a few years later, I started to feel sick again. In March 2015, I was told I had TB again but this time it was ‘pre-XDR’. When my husband found out he left me. I was trying my best to make my husband’s family happy and was ignoring my health issues. Eventually, I was transferred to Kara-Suu TB hospital, where MSF started my treatment. Now I am on outpatient treatment, meaning I can stay with my family and have their support and care. Every day I feel myself getting better and healthier.”