Transforming DR-TB Care in Rajasthan
This pilot project aims to develop an improved patient centric model for DR-TB care in public sector. It will look at reducing the touch points, improving linkages and facilitating decentralization in order to provide better care to the patient.
- Objectives
- Activities
- Expected outcome
- Ensure that all presumptive DR-TB patients complete procedure of diagnosis and treatment in a timely manner
- Minimize the touch points for DR-TB patients and simplify the patient pathway
- Improve coordination between DOTS Centers, District DR-TB centers, Nodal DR-TB centers and Intermediately Reference Laboratory (IRL) / Culture (C) – Drug Susceptibility Testing (DST) labs to ensure all patients receive appropriate diagnosis and treatment
- Minimize dropout rate among DR-TB patients
- Supporting DR-TB patients in completing various steps in the TB continuum of care from diagnosis to completion of treatment
- Minimising the number of touch points and simplify the procedure
- Strengthening coordination to minimize leakages, improve coverage and efficiency of services
- Increase in the number of patients diagnosed as Rifampicin-resistant (RR) /Drug Resistant (DR) TB and are offered the follow up diagnostic tests
- Increase in the number of patients diagnosed as RR and are initiated on DST guided regimen
- Increase in the number of patients initiated on DST and are guided regimen at District level
- Increase in the number of house hold visits of DR-TB patients
- Increase in the number of contacted house holds getting screened for TB
- Increase in the number of patients who are diagnosed of TB among contacted house holds are initiated on Treatment
Despite suffering for long, Reshmi (26) was not given any attention by her family members as they were struggling to survive after the lockdown during COVID. By the time she visited the TB DOTS centre, she had severe symptoms such as weight reduction, blood in the sputum and fever. Her treatment did not begin for 10 days despite being declared positive as she was not traceable. Continuous follow-up by DIVINE Project DOTs Centre team revealed that she was hospitalized for termination of pregnancy. It took lot of efforts to convince her to start the CAT-1 treatment. But her condition was still deteriorating. A subsequent CBNAAT test showed her to be multi-drug-resistance (MDR). Reshmi was hospitalized as her condition further deteriorated. XDR treatment with associated drug regimen was started immediately as she also had a family history of XDR. She stabilized after weeks of medication and was discharged. Throughout the treatment, she experienced Cycloserine side effects such as confusion, suicidal tendencies and sadness. Her husband refused to support her but she could recover thanks to the emotional and nutritional support provided by the project team.
