How MSF is fighting COVID-19 in Tajikistan
Our team assessed the Republican Center TB dispensary in the capital Dushanbe. The aim is to set up a new triage approach to decrease the risk of transmission of COVID-19 between patients and staff. The proposal has been discussed and approved. It is the first time such an approach has been tried in the country.
We have developed a patient questionnaire to help with triage, built an outdoor waiting area, and improved the patient flow in the dispensary.
After a two-week pilot phase of the new triage system, we constructed an adequate triage booth for nurses. Another two outdoor waiting areas have been built in TB centres in Rudaki and Vahdat and on-the-job training has been provided for the nurses working there. With these measures in place MSF teams have observed a remarkable decrease in the number of patients waiting in corridors and an improvement in infection control in the TB dispensaries.
In Tajikistan, Doctors Without Borders/Médecins Sans Frontières (MSF) works with the Ministry of Health to detect and treat pediatric tuberculosis (TB). Drug-resistant forms of the disease remain a clinical and operational challenge.
In Tajikistan, children are particularly vulnerable to TB, and pediatric forms of the disease are especially difficult to diagnose and treat. In Dushanbe, we support the Ministry of Health to provide pediatric and family TB care, focusing on drug-resistant TB (DR-TB). Learn how you can best help in Tajikistan and other countries.
Our innovative and person-centered model of care includes tracing and testing contacts, providing child-friendly formulations, implementing new drugs, shortened regimens, and strategies to improve adherence such as family-provided directly observed therapy, a practice whereby a family member watches the patient take each dose of their medication. In 2019, 40 of the 46 pediatric patients started on DR-TB treatment in Dushanbe benefited from injection-free regimens. The remaining six patients stopped injections within the first months of treatment to follow all-oral regimens.
By the end of the year, 77 patients, including 49 children, three of whom were on treatment before 2019, were continuing with treatment. The majority (96 percent) were being treated with newer drugs. Please donate to support our work in Tajikistan and other countries around the world now.
We plan to hand over our medical activities at the HIV project we run in Kulob district to the Ministry of Health by March 2020. The project successfully brought attention to pediatric HIV, especially nosocomial modes of transmission. In early 2019, 110,040 schoolchildren (or their parents) consented to HIV testing at schools in Dushanbe as well as Kulob. Twenty of the 80 newly identified patients were from Kulob and subsequently started antiretroviral treatment. MSF has implemented the practice of HIV status disclosure to the children and by the end of 2019, more than 80 percent of the children in the cohort have had their status disclosed.