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MSF in Armenia, 2010
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In Armenia, MSF is working with the staff of the national tuberculosis (TB) programme in tackling drug-resistant tuberculosis (DR-TB).
In the 1990s, as a result of patients not completing TB treatment or using drugs incorrectly, resistant forms of tuberculosis emerged. In 2005, an MSF team started working in Yerevan, Armenia’s capital, assisting doctors with diagnosis and treatment of the various forms of DR-TB.
Regular TB treatment involves around six months of medication. Drug-resistant forms of TB require up to two years of treatment, which is expensive and is not always easily available. Treatment usually starts with a period of hospitalisation, where patients are closely monitored. Once they return home, patients must continue a gruelling treatment regimen. Many of the drugs are toxic and, for some patients suffering from side effects such as headaches, vomiting or dizziness, the regime can become unbearable.
For many patients, it is very difficult to complete the cycle of treatment. The severity of side effects was one of the most significant factors, but other patients stopped their treatment because they began to feel better. MSF tries to help patients cope with the side effects by providing individual or group counselling and offering food vouchers to ensure an optimally healthy diet. In some cases, MSF assists in the renovation of patients’ homes to ensure adequate infection control. Improving ventilation and sunlight in a house increases the chances that any TB bacteria is killed or removed from the home. In 2010 the MSF team received intensive MSF training on patient education and counselling, and revised procedures have been drawn up to attempt to further improve adherence.
Some elements of the TB programme in Yerevan were handed over to national bodies: the Armenian Red Cross has taken over the provision of social support in some districts, and the national TB programme is now responsible for providing drugs for TB patients.
Reaching rural areas
In 2010 MSF expanded the TB project into Lori and Shirak, two rural provinces in the north of the country. Working in a rural setting creates additional challenges, as some patients live long distances from clinics that they must attend on a regular basis. As a result, the MSF team has introduced new approaches to treatment and care that are more convenient for patients and enable them to live at home. This also makes it easier for patients to adhere to the treatment regime.
A total of 559 patients have started TB treatment since 2005, and 246 patients are currently receiving care.
MSF has worked in Armenia since 1988.