March 22, 2013

Kyrgyzstan is among the 27 countries with the highest burdens of MDR-TB in the world. 

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Kyrgyzstan 2013 © Vincent Tremeau

Some 9.4 million people worldwide are reported to be newly infected with tuberculosis (TB) every year. Kyrgyzstan is among the 27 countries with the highest burdens of multidrug-resistant (MDR-TB), according to the World Health Organization. #

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Kyrgyzstan 2013 © Vincent Tremeau

Aziz, 38, was diagnosed with MDR-TB two years ago. He was so thin the nurses had to give him intramuscular injections in his arms and legs instead of the gluteal muscles of the buttocks. Weight loss is a common symptom of TB. #

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Kyrgyzstan 2013 © Vincent Tremeau

This nine-month-old baby was recently diagnosed with MDR-TB. There is no guidance from the World Health Organization on the best way to treat children with drug-resistant TB. Nurses have to cut adult-formulation pills, which is imprecise and creates a greater risk of over- or under-dosing the child. #

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Kyrgyzstan 2013 © Vincent Tremeau

MSF staff is helping an MDR-TB patient adapt his house so he has his own room to sleep in order to avoid infecting his family. He is being treated at home in the hopes that this will help him adhere to the medication and improve quicker. #

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Kyrgyzstan 2013 © Vincent Tremeau

“I am finally able to be with my family and even though the treatment is difficult, I can do it because I am with them,” said Mukhtar, a 45-year-old MDR-TB patient finishing his two-year-long treatment at home. #

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Kyrgyzstan 2013 © Vincent Tremeau

Ambulatory care, or treating people outside of the hospital, is one way MSF adapts care to the patients’ needs. MSF puts the patient at the center of treatment instead of the disease. #

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Kyrgyzstan 2013 © Vincent Tremeau

Serovikov’s relatives are afraid to visit him in the hospital. Many patients like him suffer due to stigmatization around TB. #

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Kyrgyzstan 2013 © Vincent Tremeau

When Eliza, 29, was diagnosed with MDR-TB, her husband and his family rejected her. She doubts she will be able to marry again. #

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Kyrgyzstan 2013 © Vincent Tremeau

Side effects of treatment for MDR-TB include nausea, dizziness, extreme fatigue, psychotic episodes, and deafness. This can last throughout the treatment period. Patients have to take up to 20 tablets a day for two years, and for the first six to nine months must receive daily painful injections. Even after all of that, only half of those treated for MDR-TB are actually cured. #

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Kyrgyzstan 2013 © Vincent Tremeau

TB is an air-borne disease and can be transmitted by coughing or sneezing; coughing is a symptom of TB. Patients and medical staff must wear masks while inside the TB hospital to limit the spreading of the bacilli. #

Doctors Without Borders/Médecins Sans Frontières (MSF) works in the penitentiary and civilian sectors in Kyrgyzstan offering treatment for multi-drug resistant TB. In February 2012, MSF began offering comprehensive medical care for people with drug-resistant TB and people co-infected with HIV and TB in the district of Kara-Suu, southwestern Kyrgyzstan, where the rates of drug-resistant strains of TB are particularly high. Teams also offer psycho-social support to encourage adherence to the arduous two-year treatment program. While the team has helped renovate the TB hospital in Kara Suu to improve infection control, the aim is to enable patients to be treated on an outpatient basis, at clinics closer to home.