Shorter regimens proving effective in Central Asia

Since January 2017, KNCV has been treating drug resistant TB patients in the Central Asian region as part of the USAID-funded Challenge TB project. Many MDR-TB patients in this part of the world have severe forms of MDR-TB such as pre-XDR and XDR-TB. These cannot be treated with the new WHO-recommended shorter MDR-TB regimen, but require individualized regimens with new drugs.

KNCV is of the opinion that as many patients as possible should benefit from the effective and patient friendly short MDR-TB regimen, whereas (pre)XDR patients should receive new drugs and regimens as quickly as possible.

That is why KNCV developed the KNCV ‘Patient Triage’ approach, to ensure an individualized approach to rapid diagnosis and optimal treatment. This way, MDR-TB patients in Kyrgyzstan can also benefit from the short MDR-TB treatment regimen, whereas those who cannot get access to new drugs have greatly improved chance of survival.

The successful treatment of Nurlan, a 17 year old boy with MDR-TB, is illustrative for the success of the KNCV triage approach. Thanks to the KNCV Patient Triage approach, he was quickly assigned to a shorter DR-TB regimen that requires less toxic drugs, has a shorter treatment duration and a higher change of being cured compared to previously available regimens. After a month of treatment, Nurlan no longer had to fear infecting his family or friends as he was no longer infectious. Laboratory tests confirmed that the triage approach had worked! Now, four months later, he no longer has to get injections, is still non-infectious and is showing excellent improvement. Reason for celebration among the KNCV team that has been working diligently to combat the epidemic of drug resistant TB in the region:

“It’s hard to describe how happy we are today. It is crucial to recognize these small but important victories, to show that it is possible to introduce short term regimens in the Central Asian region that faces a high MDR and XDR burden. Our programmatic triage approach is correct, all is fine with the safety of new regimens, and follow up is done properly with all required criteria to switch to the continuation phase…”

The local team, and KNCV globally, is excited to see the practical impact made by the KNCV Patient Triage approach, especially in the region. We are all very happy that Nurlan can continue his treatment from home, with the assurance that a KNCV case manager will be there to support him.

KNCV has been fighting TB since its establishment in 1903. Over the past 120 years, the organization has acquired indispensable knowledge and experience in the field of effective TB prevention and care, resulting in pre-elimination in the Netherlands and significant contributions to global evidence generation, policy development and TB program implementation worldwide.

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