pmdt advocacy.pptx

8/17/2019 PMDT Advocacy.pptx

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ProgrammaticManagement of Drug

ResistantTuberculosis

Region XIIICARAGA


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BACKGROUND ON

DRUGR!"I"TANTTUB!RCU#O"I"


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De%artment of &ealt' ( National TB Control Program

Rela) an* sit bac+,An* be attenti-e li+e


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Training on PMDT for &ealt'.acilit/ "ta0

BACKGROUND ONDRUGR!"I"TANTTUB!RCU#O"I"


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1'at is MDRTB$

MultiDrug Resistant TB

A TB patient who is resistant toIsonia2i* AND Rifam%icin ( 2 of the5 rst line anti-TB drugs)


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base* on*rugsusce%tibilit/ testing

•

Multi*rug ( resistant TB 4MDR (TB5 – Resistance to at least Isonia2i* AND

Rifam%icin, with or without resistance

to other anti-TB drugs.

• !)tensi-el/ *rug ( resistant TB4XDR ( TB5

– MDR ( TB with resistance to any6uoro7uinolone and to at least one ofthe three secon* ( line in8ectable*rugs (apreo!ycin, "ana!ycin, and

A!i#acin)

C f D


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Causes of Drugresistant TB


AC9UIR!DDRUG

R!"I"TANC!

PRIMAR: DRUG

R!"I"TANC!

!)%osure to*rug

susce%tible TB

Infection ;it'*rug

susce%tible TB

Acti-e

*rugsusce%tible TB

Acti-e*rugresistant

TB

.urt'er*rug

resistance

Infection ;it'*rugresistant

TB

!)%osure to*rugresistant

TB

Exposure to

anti-TB

drug/s

Exposure to

anti-TB drug/s

Two pathways leading

to

Drug-resistant TB

C f D


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Causes of DrugResistant TB

Ac7uire* Drug ( Resistant TB – selection of !utant resistant strains,

e$entually %eco!ing the do!inant strain

– Result of ina*e7uate, incom%lete, or

%oor treatment 7ualit/

1' i* MDR TB


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1'/ consi*er MDRTB a%roblem$

•

&t is di'cult to treat. uration of ?mont's using secon* line antiTB *rugs@

• &t is epensi$e. rugs and patient support

cost P> ( P>.

• *ndetected + wrongly treated R-TB willlead to

- continuous trans!ission

- tensi$ely rug Resistant TB (/R TB)

- death


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Pre-entDrugResistant TB

0. arly detection and high 1uality

treat!ent of drug-suscepti%le TB.2. arly detection and high 1uality

treat!ent of drug-resistant TB.

. 3ecti$e i!ple!entation of infectioncontrol !easures.

4. trengthening and regulation of health

syste!s.5. Addressing underlying ris# factors and

social deter!inants.

> &i ' MDR TB


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> &ig' MDRTBBur*en Countries

t' a!ong the 26 7igh

Burden ountries in ter!sof RTB esti!ates

879 :lo%al Report 2;04


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Casest'at &a-e MDR ( TB in > TB

Burdenountries

4.;< 22<

=hilippines >@F >


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>


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>


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C!N"U"

C!N"U" O. !NRO##!D MDRTBPATI!NT" in CARAGA R!GION

(starting fro! 2;00 up to thepresent)


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C!N"U"

PMDT CARAGA

C!N"U" O. !NRO##!DJ>


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C!N"U"

;

5

0;

05

2;

25

;

5

4;

45

2;

6

42

@

!nrolle*

.nrolled


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ProgrammaticManagement of

Drugresistant TB4PMDT5

Management of


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Management of Drugresistant TB4PMDT5

•

A collecti$e strategy using thedi3erent co!ponents of the national

TB control progra! to e3ecti$ely!anage drug-resistant tu%erculosis.

• &t include acti$ities on case*etection treatmentsur-eillance monitoring an*e-aluation of t'e %rogramLs%erformance@


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ID!NTI.ICATION O.

PR!"UMPTI! DRTB an* D9uali3e* for GX Testing

Case .in*ing for PMDT



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Bacteriologically

Confirmed RR-TB

Referring

Unit

PMDT.acilit/

I*enti3cation an*

referral ofPresum%ti-e DR TB "creeningassessment

s%utumcollection

Case .in*ing "trateg/ for

PMDT

Xpert

TB/R!"

Test

Rifam%icin

resistant

#ung Center of t'e P'ili%%ines National Center for Pulmonar/


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Test

• Roll-9ut and *se of TB+Rif :ene/pert as %rimar/

*iagnostic tool for MDRTB

• &!pro$ing Turnaround Ti!es fro! 4-5 !onths for diagnosis ofRTB to > 'ours for *iagnosis of Rifam%icin Resistance


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=resu!pti$e rug-suscepti%le TB

(-TB) satisfying at least one of thefollowingC• ?ew cases who are negati$e

%ut with chest /-ray ndingssuggesti$e of TB.

• ?ew cases who are hildren with

presu!pti$e TB.• ?ew cases who are =resu!pti$e

etra-pul!onary TB.

D"TB



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• =resu!pti$e TB (whether adult,

adolescent or child) who %elongs to anyof the RTB high-ris# groups, such asC

–Retreat!ent cases

–?ew TB cases that are contacts ofconr!ed R-TB cases

–?ew TB cases that are non-con$erter

of ategory 0 –=eople li$ing with 7&D with signs and

sy!pto!s of TB

DRTB



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PMDT Referrals

Nee*e* Re7uirements


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Nee*e* Re7uirementsfor PMDT Referral

o!pletely lled ?T= Referral Eor! =hotocopy of ?T= Record result ( should not %e !ore than 0 !onthold)

/R reading ( w+ in !os.) /R l!Refer toCARAGA Regional &os%ital ( Treatment Center

"atellite Treatment CenterA*ela "erra T/ Memorial Me*ical CenterButuan Me*ical CenterBislig District &os%ital


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Referrals

creening and Testing is ERFFF Ga%oratory a!ination is ERFFF edicines for the whole course of

treat!ent is ERFFF 8ith =atient na%ler (allowance)

R!GION XIII PMDT


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R!GION XIII PMDT.acilities

Agusan *elNorte

Pro-incial&os%ital (

AgusanNorte

E?

"iargaoDistrict&os%ital

"iargaoIslan*s

"DN

aragRegional7ospital >

urigao ity=>>EEH


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Partners


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Hoin us in the Eight againstRTBF

pmdt advocacy.pptx

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