Optimizing outcomes for drug resistant tuberculosis patients through provision of a comprehensive care package

Authors

  • Aurangzaib Quadir Former Deputy National Coordinator (Tuberculosis) CMU, Islamabad, Pakistan
  • Abdul Ghafoor National Adviser (USAID) on MDR-TB, Islamabad, Pakistan
  • Syed Karam Shah Stop TB Pakistan, Islamabad, Pakistan
  • Shahid H. Khokhar Stop TB Pakistan, Islamabad, Pakistan
  • Hussain Hadi Former Policy Advisor National TB Control Program
  • Ghulam Nabi Kazi Dopasi Foundation, Islamabad, Pakistan
  • Kinz ul Eman Dopasi Foundation, Islamabad, Pakistan
  • Sher Afghan Raisani Provincial TB Control Program
  • Zaeem ul Haq Independent Consultant

DOI:

https://doi.org/10.32413/pjph.v12i1.958

Keywords:

DR-TB, Pakistan, drug resistance, Comprehensive care package, PMDT, NTP, USAID, STP, second line TB drugs, side effects

Abstract

Background: The paper presents the salient features of a comprehensive treatment package for drug resistant tuberculosis (DR-TB), its adaptation and implementation in two indoor care hospital settings in Pakistan, and lessons learned from this implementation. 

Methods: A pilot study was undertaken on a group of 100 patients at two Programmatic Management of Drug-Resistant TB (PMDT) sites. Fifty patients each were selected from the Samli Sanatorium Murree and the Lady Reading Hospital, Peshawar by the National Tuberculosis Control authorities, and delivered a comprehensive package of services, including psychosocial and food support. Data were collected using standard TB tools and surveillance indicators. The results were compared between intervention and a historical cohort of DR-TB patients. 

Results: Among the total 100 patients, the treatment success rate was 88%, the failure rate was 4%, while there were 7% deaths. A patient was transferred out while none were lost to follow-up, indicating much improvement over the historical cohort. Patients ranked the economic support, free medicines and nutritional support as most helpful, while majority of providers found the intervention sustainable. 

Conclusion: A comprehensive package including the psychosocial support can be crucial in enhancing DR-TB outcomes. Regular interaction with patients and improved nutrition leads to improved treatment adherence, while capacity building of psychologists and home visits can further benefit the DR-TB patients leading to their cure.

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Published

02-05-2022

How to Cite

Optimizing outcomes for drug resistant tuberculosis patients through provision of a comprehensive care package. (2022). Pakistan Journal of Public Health, 12(1), 8-12. https://doi.org/10.32413/pjph.v12i1.958