1. Programmatic management of multidrug-resistant tuberculosis: models from three countries.
- Author
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Furin J, Bayona J, Becerra M, Farmer P, Golubkov A, Hurtado R, Joseph JK, Keshavjee S, Ponomarenko O, Rich M, and Shin S
- Subjects
- Community Health Services organization & administration, Cooperative Behavior, Delivery of Health Care, Integrated economics, Financing, Personal, Health Care Costs, Health Services Accessibility economics, Health Services Needs and Demand economics, Healthcare Disparities, Humans, Lesotho epidemiology, National Health Programs economics, Organizational Objectives, Patient Care Team organization & administration, Peru epidemiology, Program Development, Program Evaluation, Russia epidemiology, Time Factors, Treatment Outcome, Tuberculosis, Multidrug-Resistant diagnosis, Tuberculosis, Multidrug-Resistant economics, Tuberculosis, Multidrug-Resistant epidemiology, Vulnerable Populations, Antitubercular Agents therapeutic use, Delivery of Health Care, Integrated organization & administration, Drug Resistance, Multiple, Bacterial, Health Services Accessibility organization & administration, Health Services Needs and Demand organization & administration, Models, Organizational, National Health Programs organization & administration, Outcome and Process Assessment, Health Care economics, Tuberculosis, Multidrug-Resistant drug therapy
- Abstract
Background: Although multidrug-resistant tuberculosis (MDR-TB) is a major global health problem, there is a gap in programmatic treatment implementation., Methods: This study describes MDR-TB treatment models in three countries--Peru, Russia and Lesotho-- using qualitative data collected over a 13-year period., Results: A program analysis is presented for each country focusing on baseline medical care, initial implementation and program evolution. A pattern analysis revealed six overarching themes common to all three programs: 1) importance of baseline assessments, 2) early identification of key collaborators, 3) identification of initial locus of care, 4) minimization of patient-incurred costs, 5) targeted interventions for vulnerable populations and 6) importance of technical assistance and funding. Site commonalities and differences in each of these areas were analyzed., Conclusions: It is recommended that all programs providing MDR-TB treatment address these six areas during program development and implementation.
- Published
- 2011
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