Submission ID 116326
| Issue/Objective | To evaluate the implementation of community-based intensive-phase of MDR-TB treatment pilot that would inform decentralizing MDR-TB treatment centers to mitigate the disease burden. |
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| Methodology/Approach | A prospective cohort study with real-time data collection was adopted, where all six patients spent about six months in the National TB Hospital before transition in the community-based treatment pilot. The Hospital Management held engagement meeting, involving health workers, patients and their family caregivers to explain the aims of the pilot. Patients signed consent forms before discharge from the TB Hospital. Each patient had at least 3 consecutive negative sputum smears using Acid-Fast Bacillus before enrolling the community-based treatment. Laboratory monitoring, including audiometric exams were conducted, health education on infection control, drugs adverse effects were provided to patients and their families by Nurses. Drug treatments included Kanamycin, Levofloxacin, Cyclomerize, Ethambutol, Ethionamide, Pyrazinamide and Pyridoxine. |
| Results | Fifty (50%) of the patients were males and 50% females. The overall recovery rate was 100%; no defaulter nor death. The patients' age ranged from 20-35 years, with mean age 26, while 50% were between 25-29 years old. The average length of stay during the intensive treatment phase was 224 days (8 months). The average days spent in the community-based treatment were 53, minimum and maximum days of 33 and 51. Improved patients' satisfaction, reduced caseload on clinicians and rigorous promotion of IPC practices, cough etiquette were observed amongst patients. |
| Discussion/Conclusion | Addressing TB is a key priority in Liberia, but human resource and facility capacity constraints remain in managing MDR-TB. Once patients are stabilized with at least 3 consecutive negative AFB smears, they can be safely transitioned to home-based treatment, with routine follow by trained health professionals; which reduces crowdedness in facility and improve recovery. |
| Presenters and affiliations | Alice A Aggrey Ministry of Health Moses A Bolongei World Health Organization Liberia Anthony Tamba Ministry of Health Liberia |
