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MSF in Uzbekistan, 2006
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MSF is one of the few humanitarian organizations present in Uzbekistan, where a combination of increasing economic hardship and deterioration of tuberculosis services in the 1990s has led to an increased incidence of tuberculosis (TB). This is most evident in the region of Karakalpakstan, which is also confronting economic problems caused by massive environmental degradation in the Aral Sea area.
In 2001/2002, MSF conducted a drug resistance survey in Karakalpakstan, showing levels of multi-drug-resistant TB (MDR-TB) that are among the highest in the world. Thirteen per cent of people never before treated for TB were infected with MDR-TB, and 40 per cent of re-treatment cases were infected with this strain. MDR-TB is defined as resistance to the two most powerful anti-TB drugs, isoniazid and rifampicin. It is a man-made phenomenon caused by poor patient management, poor adherence to prescribed regimens, poor program management, or a combination of these factors.
MSF began its MDR-TB program in Uzbekistan 2003, focusing its activities in Nukus City and Chimbay District in the autonomous republic of Karakalpakstan. By May 2006, a total of 246 MDR-TB patients had been enrolled in the program.
MDR-TB is a very difficult disease. Treatment has very unpleasant side effects and involves hospitalization for six to 12 months. Afterwards, patients have to be treated in the ambulatory phase for about a year. The MSF team continues to try to improve the quality of life for patients by offering psychosocial assistance to them and their families, placing much emphasis in 2005/2006 on the supervision of patients who are living in the community, but who must still take medication six days per week.
In collaboration with the Ministry of Health, MSF recently opened an additional inpatient TB ward in the TB 1 hospital of Nukus City. The ward has 30 inpatient beds designated for patients with PDR-TB (poly drug resistant tuberculosis), yet another form of tuberculosis that shows resistance to certain drug protocols.
MSF has worked in Uzbekistan since 1997.