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MSF in Georgia, 2011
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The incidence of kala azar (visceral leishmaniasis) is increasing in Georgia, and most cases are being reported in urban areas, such as the capital Tbilisi.
Kala azar is a parasitic disease transmitted to humans and animals through the bite of a certain kind of sandfly. It is not known for certain why the incidence in Georgia has risen, but deforestation and large-scale migration from rural to urban areas have been suggested as possible explanations. Symptoms of kala azar include fever, weight loss, anaemia and enlargement of the spleen and liver. If left untreated, the disease is fatal.
In Tbilisi, Doctors Without Borders/Médecins Sans Frontières (MSF) has launched a kala azar program in collaboration with the city’s Parasitological Hospital. MSF staff provide initial training in diagnosis and care, and hospital staff then take on program management and patient treatment. More than 130 people were admitted to the program in 2011, some 70 to 80 percent of whom were children.
MSF has introduced rapid testing, which is less expensive and far less complex and invasive than previous screening methods, which required bone marrow samples. A new treatment regime has also been implemented, using the drug liposomal amphotericin B. Treatment now takes just 10 days, rather than 30.
Mortality rates for people with tuberculosis (TB) have declined in Georgia, but the number of deaths remains high. Multi-drug-resistant tuberculosis (MDR-TB) is one of the main reasons for this. MSF is treating patients with drug-resistant forms of TB in the autonomous republic of Abkhazia.
MDR-TB is contagious, and can be transmitted through the air when an infected person sneezes or coughs, or it can develop when a patient becomes resistant to at least two of the standard TB drugs, either through mismanagement or misuse of medication. Treatment is difficult: it can take up to two years and causes severe side effects. In June 2010, after 11 years of treating patients for TB, MSF decided to hand over the program to local medical authorities.
In 2011, the team worked to support the restructuring and strengthening of the Abkhazian TB program, in preparation for the handover. MSF also continued to offer health education and counseling to help patients adhere to treatment. Since January 2010, 208 patients have started treatment for TB.
At the end of 2011, MSF had 72 staff in Georgia. MSF has been working in the country since 1993.