Multidrug resistant tuberculosis (MDR-TB) is a strain of TB that cannot be treated with the two most powerful drugs that are most often used to treat the disease. Extensively drug resistant tuberculosis (XDR-TB) is a form of the disease caused by bacteria that are resistant to several of the most effective anti-TB drugs. Today, MDR-TB and XDR-TB threaten to reverse the global progress made in TB care and control.
Drug resistance occurs when TB patients do not receive the correct treatment regimens or do not complete the full course of treatment. Nearly 10 percent of the world's TB patients have MDR-TB and 9 percent of these patients also have XDR-TB. Although all forms of TB are highly contagious, drug-resistant TB can be particularly challenging to control due to a longer treatment period and more costly drug regimes.
To tackle MDR-TB and XDR-TB, MSH helps national TB programs and ministries to implement MDR-TB programs that focus on an effective programmatic approach, a strong clinical management strategy, a well-functioning laboratory system, and a sound drug management system.
Once these components of a MDR-TB program are in place, we then support national TB programs and ministries of health to:
- Train health workers to effectively screen for, diagnosis, and treat MDR-TB
- Expand MDR-TB prevention and care initiatives to include more women and children
- Establish an MDR-TB patient tracking system
- Implement the e-TB Manager to manage all TB program data
- Improve health facility systems and expand community-based approaches for MDR-TB control
- Conduct operational research on MDR-TB interventions, patient support, and treatment outcomes to inform future programming
MSH also developed the Multidrug Resistant TB (MDR-TB) Cost-Effectiveness Analysis Tool, which compares the cost-effectiveness of different MDR-TB service delivery modalities to help program managers select those that produce the best results at the lowest cost.
- Through the global SIAPS program, MSH helped to design e-TB Manager, a health systems strengthening platform for managing information needed by national TB programs that integrates data across most aspects of TB prevention and care, including reporting and follow-up on presumptive and confirmed TB and drug-resistant cases, medicines management, and laboratory testing. Globally, more than 3,500 active e-TB Manager users are managing more than 420,000 TB cases, MDR-TB cases, and presumptive TB individuals.
- In Uganda, through the TRACK TB project, MSH helped develop and implement a model of MDR-TB care that increased service delivery sites from 3 to 15 and provided various forms of patient support through the TRACK TB project.
- In Ethiopia, through the HEAL TB project, MSH supported the renovation of three MDR-TB treatment initiating centers and assisted with the enrollment of 704 new MDR-TB patients on treatment. The project is helping reach the national target of treatment success rate for MDR -TB in the Amhara and Oromia regions.