Kazakhstan: TB control and treatment

National staff : 30
International staff : 8

Since August 1998, Directly Observed Treatment Short course (DOTS) chemotherapy protocol of the World Health Organisation is accepted by the government. However, MSF introduced DOTS treatment in Kazakhstan as early as 1996 when a TB programme was launched in the Aksy Hospital covering the districts of Ily and Balkhasch and Kapjigai city.

MSF rehabilitated the hospital, which has since become the regional referral hospital. MSF has also put in place three new laboratories in order to improve screening for TB. The MSF programme in Aksy targets a population of 190,000. Treatment lasts six months and is made up of a two-month period of hospitalisation, followed by four months of treatment at home. Patients go to their local health centres for their medication.

Five people are diagnosed with tuberculosis in SKO every day, and at least one person dies daily from TB. MSF now targets a population of 150,000. In Baidebek region, patients were first taken onto DOTS treatment in December 1997. MSF teams work out of Shimkent Hospital which was entirely rehabilitated in August 1998.

MSF makes regular visits to all villages covered by their programme to identify and follow the progress of patients in the second phase of treatment. Staff in the health centres try to trace the defaulters and encourage them to return to finish their course because incomplete treatment results in greater risks for TB infection and increased drug resistance. Training of local medical staff, and public health education are priorities.