National Reference Laboratory staff carry out daily routine work while taking necessary precautions and observing strengthened infection control measures during the height of the COVID-19 pandemic. Photo credit: Cure Tuberculosis Project

Cure Tuberculosis Project

The Challenge

The Kyrgyz Republic is one of 30 countries with the highest burden of multi-drug resistant TB (MDR-TB or DR-TB). There are an estimated 1,400 new cases of DR-TB annually. DR-TB is difficult to treat as diagnosis requires collecting sputum from patients for testing in specialized laboratories. The course of treatment for DR-TB is long and requires many different drugs which cause serious side effects.

Overview and Objectives

The USAID Cure Tuberculosis Project, implemented by JSI Research & Training Institute, Inc. (JSI) in partnership with URC, is a five-year initiative that assists the Kyrgyz government to diagnose, treat, and cure people with DR-TB.

Cure Tuberculosis works closely with the National Tuberculosis Program under the Ministry of Health and Social Development and national partners to ensure that TB services are both high-quality and accessible, especially for the hardest to reach citizens.

As stigma and discrimination often prevent people from accessing treatment, the project works to reduce TB stigma and discrimination among health care providers and the general public in an effort to ensure that all people with TB have access to treatment.

To reduce the burden of DR-TB, the project strengthens the Kyrgyz government’s efforts to:

  • Design, manage and monitor a system of high-quality TB services available at local health care facilities;
  • Ensure that all patients receive the correct treatment regimen with high-quality drugs;
  • Strengthen laboratory and diagnostic services;
  • Improve infection control in health facilities and laboratories; and
  • Expand detection and contact-tracing capabilities in communities and health facilities.

URC is responsible for implementing the clinical component of the project.

Achievements

URC has attained significant achievements to prevent DR-TB infections, increase DR-TB case detection, and cure more DR-TB patients.

To improve DR-TB case detection and strengthen DR-TB laboratories, URC developed:

  • Four oblast regional infection control plans following IPC assessments;
  • IPC system strengthening mechanism for TB hospitals;
  • Training programs for TB laboratory quality improvement; and
  • Standard TB reporting forms for monitoring and analysis.

We implemented a Quality Management System in first-level laboratories.

To cure more DR-TB patients, the project has strengthened the DR-TB Concilia, the Kyrgyz Republic’s medical council that makes decisions about DR-TB cases, in Chui Oblast, with rollout to other pilot regions. Cure Tuberculosis has also developed an advanced DR-TB training curriculum based on MOH-approved national clinical guidelines on management of DR-TB.

URC has assisted the National TB Program and National Reference Laboratory repurpose functions for COVID-19 treatment and testing and revised infection control procedures. The project developed and piloted a combined diagnostic algorithm for TB and COVID-19.

Duration
2019–2024

Countries
Kyrgyz Republic

Regions
Asia

Expertise
COVID-19, Global Health Security, Health Service Delivery, Health Workforce, Implementation Science, Quality Health Systems, and Tuberculosis

Funders
USAID

Partners
JSI Research & Training Institute, Inc., Mandatory Health Insurance Fund (MHIF), Ministry of Health and Social Development of the Kyrgyz Republic, and National Tuberculosis Program (NTP)