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Posted By: Alexander Trusov, M.D., Ph.D. on June 17, 2016

Labels: Europe and Eurasia, Kazakhstan, Kyrgyzstan, Malawi, Namibia, Tajikistan, Uzbekistan , Infectious Disease

Shortened TB Treatment

Hundreds of thousands of patients with multidrug resistant tuberculosis (MDR-TB), a form of TB infection caused by bacteria that are resistant to powerful drugs used to cure the disease, suddenly have reason to hope. The World Health Organization (WHO) has just cleared a new shortened treatment regimen for multidrug-resistant tuberculosis (MDR-TB) which carries grave risks for nearly half a million people who developed a condition that killed 190,000 people in 2014.

The disease is so pernicious that it cannot be treated with the standard six-month course of medication which is effective in most TB patients. Patients with rifampicin-resistant or MDR-TB are treated with a different combination of drugs, usually for 18 to 24 months.  But the regimen is arduous and can have terrible side effects.

The WHO recommendation shortened the treatment plan by nine months. The treatment duration in the new regimen is 9-12 months instead of 18-24 months.  This means treatment will be less grueling for patients and less burdensome on already stretched health systems in many parts of the world. And the cost of the drugs required for treatment will drop to less than $1,000 per treatment course.  This is a leap forward for MDR-TB patients, but there is still a long way to go because the WHO’s new recommendations on the use of a shorter MDR-TB regimen come with specific conditions and there are serious risks for worsening resistance if the new regime is used inappropriately (e.g. in XDR-TB patients). Project HOPE is supporting national programs in the Central Asia region through strengthening monitoring and evaluation of the programs and to implement WHO guidelines.

In a USAID funded program in Central Asia, Project HOPE has already discussed with national programs how to use the shortened regimen in pilot programs under stringent monitoring.  It is really a big step forward - and a very important one for patients who now face shortened treatment periods and can return to their normal lives more quickly.

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