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ArmeniaArmenia has one of the world’s highest incidence rates of drug-resistant tuberculosis (DR-TB). In September 2005, in collaboration with the Armenian Ministry of Health, Doctors Without Borders/Médecins Sans Frontières (MSF) started a pilot program for diagnosis and treatment of DR-TB in the capital city, Yerevan, where almost half the country’s population lives. Since then, response to the DR-TB epidemic in the country has improved, with support from international agencies and donors helping to strengthen local capacity. At the national level, MSF is advising on the implementation of a directly observed treatment short course. MSF’s DR-TB program in Yerevan covers the city’s population of approximately 1.2 million. Once DR-TB has been diagnosed, patients receive initial treatment at the inpatient unit where MSF has refurbished a 35-bed facility. When patients are no longer contagious, they are discharged and their treatment continues via mobile polyclinics or home-based care until it is complete. Adhering to the treatment is not easy, since it requires taking handfuls of drugs daily and can take 18 to 24 months to complete. There are often side effects. MSF provides multidisciplinary services to encourage adherence to treatment. Teams of doctors, nurses, psychologists, and social workers assist patients in different ways and emphasize the importance of finishing the course. MSF offers social support to the patients and their families. Food parcels help ensure a balanced diet. A transport allowance covers the costs of getting to the clinic every day. Heating allowances help make the coldest months of winter bearable. More than 200 patients have been admitted to the program since September 2005. MSF has worked in Armenia since 1988. |
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