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Follow up of treatment of Drug Resistant TB patients after release from prison. Irada Akhundova M.D. Ph.D., Scientific Research Institute of Lung Diseases Baku, Azerbaijan 14 th Annual Congress of Turkish Thoracic Society 13-17 April, 2011, Antalya, Turkey.
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Follow up of treatment of Drug Resistant TB patients after release from prison Irada Akhundova M.D. Ph.D., Scientific Research Institute of Lung Diseases Baku, Azerbaijan 14th Annual Congress of Turkish Thoracic Society 13-17 April, 2011, Antalya, Turkey
Start of pilot project for released Drug Resistant TB patients There was a great need to organize continuation of treatment for DR-TB patients after release from prison • DOTS-Plus treatment in prison started April 2007 and the patients with more than 2 year sentence were one of the(last but not least) criteriafor enrollment. - April 2009(upon start of follow up) 135 DR-TB patients were enrolled in prison who were mainly with sentences more than 2 years. - May 2008, when DOTS-Plus project started for civilian patients and there were trained staff in civilian sector regarding MDR management... - ...the ICRC started to initiate piloting follow up of released DR-TB patients in cooperationwith MoJ and NTP.
TRIPARTITE AGREEMENT March 17 2009, the Memorandum of Understanding on the follow up of released Drug Resistant TB patients to complete their treatment in civilian anti-TB fasilities was signed between MoH, MoJ and ICRC.
Start of pilot project for released Drug Resistant TB patients • On the basis of tripartite agreement DR-TB patients released from prison without completing treatment were transferred with transport out to civilian TB facilities.
The number of Drug Resistent TB cases released while being under DOTS-Plus treatment in prison Since April 2009, 50 DR-TB patients were transferred out to civilian sector Coverage: Whole country 2009 -17 patient 2010 – 24patient 2011 - 8p.
Continuation of treatment is organized for DR-TB patients in civilian sector
Follow up form The form is created for each released DR-TB patient to register bacteriological status of the patient every month.
Patients' bacteriological status Most of the patients release from prison with culture negative. Every month sputum specimens are collected from each patients for smear, culture, DST and transported to prison Lab Any changes in treatment is done by concilium (technical expert commition)
Interim treatment outcomes • 50 patients were released from DOTS-Plus Project in prison • 49 of them released after MOU was signed by MOJ,ICRC,NTP • 13 cured • 8 defaulted • 4 failure • 2 died • 1 Transfer in to prison (re-jailed) • 22 under treatment
Experience and implementation mechanism of the project The followings were gained during piloting follow up project; • Valuable experience • Implementationmechanism • Project set up • Recording and reporting system • Infrustructure • Trained staff • Resources Due to the ICRC phase out of health program, the follow up project will be carried out by the NGO – “Health Care Support” who mainly is involved in TB, HIV and other communicable diseases according to its regulation.