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Tanzania a low MDR-TB burden country according to the drug resistance survey conducted in 2017/2018 with results showing overall prevalence of MDR -TB of 1.2%. The highest burden is recorded previous treated TB patients where the prevalence 4.6% and 0.97% among new TB patients. The MDR-TB burden has remained stable for over a decade as compared to the previous survey conducted in 2006/2007 where the prevalence was 1.1 and 3.9% in new and previous treated TB patients respectively.
For the past 7 years there have been an overall upward trend in RR/MDR/Pre-XDR-TB notification with a slight drop in notification between 2019 and 2021. This trend is also reflected in number of patients enrolled to treatment among notified patients in the same period which ranged from 67% in 2015 to 99% in 2021. In the 2021 the number of RR/MDR/Pre-XDR-TB patients notified is 442, out of these 6 are Pre-XDR -TB patients who are RR/MDR-TB with additional resistance to Fluoroquinolone one of the key medicines used in MDR-TB treatment. The notified patients included 6 paediatric RR-TB patients. Among the notified patients 438 (99%) were enrolled into MDR-TB treatment in 2021. RR/MDR TB notification is below the programme target where it has achieved 56% of notification target of 800 RR/MDR -TB patients in 2021.
Figure 16: Trend on RR/ MDR-TB notified and enrolled to treatment 2015 - 2021
The notification varies from region to region; Dar es salaam notified largest proportion of 87 (20%), followed by Morogoro 31 (7%), Lindi 29 (6.6%), Arusha 21(5%), and Manyara 22 (5%) remaining regions notified at least 1 patient except Pemba did not have any RR/MDR TB patient in 2021.
Figure 17: Trend on RR/ MDR-TB notified and enrolled to treatment 2021 by region
The notification varies from region to region; Dar es salaam notified largest proportion of 85 (19%), followed by Morogoro 31 (7%) 29 (6%), Arusha 22(5%), and Manyara 22 (5%) remaining regions notified at least 1 patient except Pemba did not have a RR/MDR TB patient in 2021.
Since 2016 MoH started to decentralise MDR TB services from Kibong’oto Infectious Diseases Hospital which was the only centre initiating treatment to RR/MDR TB patients. The number of health facilities initiating DR-TB treatment has increased up to 304 by the end of 2021. Out of these six health facilities (Kibong’oto, Bugando, Muhimbili National Hospital, Dodoma Regional Referral Hospital, Sumbawanga Regional Referral Hospital and Mbinga District Hospital has capacity to admit patients who cannot be managed on ambulatory basis.
Among 518 patients enrolled to long and short MDR TB treatment in 2019; 378 (73.0%) were successfully treated (cured + treatment completed). Those with unfavourable outcome includes 99 (19%) patients who died, 28 (5%) patients were lost to follow up and 1 patient failed treatment. However, there were 12 patients who were not evaluated among the 518 and were included in denominator during calculation of proportion of the results above. Stratification by treatment regimen indicates that patient enrolled in shorter treatment regimen (injectable based) 199 had treatment success of 80% while 229 patients enrolled in longer regimens had treatment success of 63%. This partly can be explained by the eligibility criteria for enrolment into the shorter regimen which excludes severely ill patients. The treatment success rate has declined from 83% in 2017 to 73% in 2019.
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