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Tajikistan is a country in Central Asia with roughly 8,5 million population of which 85% is Tajik. Ninety-three percent of Tajikistan’s territory is mountainous, and the mountain glaciers are the source of its rivers. The republic is bordered by China in the east, Afghanistan to the south, and Uzbekistan and Kyrgyzstan to the west and north.

After the collapse of the Soviet Union, Tajikistan declared its independence in 1991. Although Tajikistan was always one of the poorest countries in the Soviet Union, the country suffered a particularly severe economic decline and collapse of social infrastructure when the Soviet Union dissolved, which was followed by several years of civil war. Tajikistan is one of the few countries that have quickly moved from civil war to internal stability and economic growth. As in the Soviet period, cotton and aluminum production continue to dominate Tajikistan’s economy. Poverty levels remain high.

Tuberculosis in the country

With annually around 6000 TB and 700 DR TB cases detected annually Tajikistan is among the 27 high multidrug-resistant tuberculosis (MDR-TB) burden countries in the world. The TB detection rate is very low and there is still a lack of human resource capacity to manage TB control, especially in rural areas at primary health care level.

KNCV Activities in the country

Tajikistan is a country where the Challenge TB program is active. Challenge TB is USAID’s flagship global mechanism for implementing USAID’s TB Strategy and is led by KNCV Tuberculosis Foundation, who also led USAID’s previous TB Control projects TB CARE I, TB CAP and TBCTA.

In total 228 health providers were trained to help patients be treated with new drugs and regimens

In Tajikistan KNCV successfully started the enrollment of patients on new drugs and shorter regimens, using the KNCV Patient Triaging Approach. The enrollment covers patients from Dushanbe, the capital, and Rudaki District. Based on WHO recommendations, we made all the necessary preparations, including policy development and producing the necessary technical documents through the Challenge TB project. Guidelines and a national plan were approved by the Ministry of Health, including revised recording and reporting forms. We also developed clinical protocols and optimized the diagnostic algorithm needed to assess the right treatment for every patient.

KNCV helped to develop a country implementation plan to introduce shortened drug-resistant TB treatment and new TB drug regimens including an active drug safety monitoring system.

To manage adverse events and prevent serious side effects, we established a system for drug safety monitoring and management, and supported the procurement of necessary equipment, such as ECG machines, ultrasound scanners, audiographs, negatoscopes, and mechanical scales. We also trained TB and primary healthcare staff to manage patients on new treatment regimens. In total 228 people were trained: health providers including physicians and nurses, laboratory specialists, consilium members and representatives of the State Pharmaceutical Control Service, as well as 87 drug management specialists who received an updated Logistic Management Information System training.

All these preparations will now make it possible to help patients suffering from MDR/XDR-TB, for whom these new drugs and regimens are life-saving.