Tajikistan

Modified Shorter Regimen Treatment gives hopes for better and faster treatment of TB patients in Tajikistan

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Ehson, 25, has come a troubled way to his dream of having a family. After a two-year-long construction of his house, where he would move with his wife-to be, Ehson has held a small wedding ceremony in fall of 2020 because of the COVID-19 pandemic restrictions. It was not the big wedding he had hoped for, but he was happy to settle down and start his own family. When Ehson fell ill shortly after he assumed he had contracted COVID-19, but there was a surprise in the medical check for him: Ehson tested positive for multi-drug resistant form of tuberculosis, or MDR-TB.

According to WHO data, there are approximately 7600 people infected with all forms of tuberculosis in Tajikistan. The National Tuberculosis Programme has achieved some positive results, decreasing the death rate from TB from 5.9 to 3.1 people per 100 thousand population within ten-year period. Yet, Tajikistan remains in the list of 27 countries with high rate of drug resistant tuberculosis infection. For many patients this means undergoing intensive therapy of heavy and toxic drugs, lasting up to two years.

Ehson is lucky to have been offered the new short-term regimen rolled out in 31 districts of the country to contain the spread of tuberculosis and provide medical services to TB patients. “I remember the day I was told one bad and one good news: The bad news was that I had confirmed multi-drug resistant TB test result, and the good news was that the doctor informed me about a new modified short-term regimen to complete the treatment in shorter time,” Ehson says.

“I was so upset to know I have TB with resistance to the regular TB medicines, and that the MDR treatment usually takes two and more years. My doctor was very patient as I panicked and consulted me on the details of the new treatment available, so I agreed to start the treatment with new modified drugs immediately as I wanted to be back to my family as soon as possible,” he adds.

Despite the challenges related to pandemic restrictions, the National Tuberculosis Programme (NTP) continuously provides services to the population including implementation of modified new shorter regimens. In 2021 with financial support from the Global Fund UNDP has helped the national programme to gradually roll out Modified shorter treatment regimen to cover 50 per cent of the country’s districts as a scale-up of the positive piloting results reported earlier by the NTP.

Patients across these districts, who have rifampicine resistant form of TB, are transferred to the new treatment scheme, reducing their treatment time from an average of 1.5-2 years to a shorter period of six to nine months. By October 2021, 76 patients with drug resistant forms of TB have switched to the new treatment scheme. Ehson is one of the five patients who have already completed the treatment and reported as fully cured. His treatment has lasted nine months. Soon after the recovery Ehson fathered to a healthy born son.

“I am happy for this chance, I thank doctors who despite the hard times of pandemic were caring about me. I am grateful to my wife and my family, I am happy my country had opportunities to get new medicine and improving health services and I appreciate support from donors and organizations that provide chances for such treatment in Tajikistan” Ehson says in an emotional response to members of the medical Concilium that informed him he was fully cured.

The Global Fund provides funds to Tajikistan to eliminate TB since 2007. In 2021, Tajikistan received another fund under HIV and TB consolidated grant to continue interventions started during previous years. The current grant, implemented by UNDP, aims to provide adequate and timely TB services to population of Tajikistan gradually reaching 100% coverage and to mitigate the impact of Covid-19 to reach all key population and missed patients.