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Multi Drug Resistant Tuberculosis (MDR-TB):
Tanzania is still a low DR-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 burden is not evenly distributed among types of TB patients where the prevalence among new and previous treated TB patients is 0.97% and 4.6% respectively. The MDR-TB burden has remained stable for the past decade as shown in the 2006/2007 survey the prevalence among new and previous treated TB patients was 1.1 and 3.9% respectively. Decentralization of MDRTB services has continued where by 34 new facilities have enrolled patients to make a total of 177 health facilities which have managed to initiate DR-TB patients into treatment covering all regions in the country. The country has introduced and scaled up of all oral MDR TB regimens both shorter and longer. Capacity building to Health care workers is the key to successful introduction of the all-oral regimens this have been accomplished through form PMDT trainings, weekly online PMDT sessions through MDR -TB ECHO, mentorship and Supportive supervision.
MDR-TB Notification and Enrolment to treatment
Tanzanian TB and Leprosy Program (NTLP) scaled up new diagnostics, particularly GeneXpert from 70 in 2015 to 259 machines installed in 224 sites by end 2020. This resulted in increased RR/MDR-TB notification and enrolment into treatment. RR/MDR-TB notification increased from 178 in 2015 to 423 patients in 2020 the trend on detection and enrolment of RR/MDR-TB patients into treatment are displayed in figure 9. This notification is 71% of the year 2020 target which was 600 RR/MDR -TB patients. The notification varies from region to region where Dar es salaam notified largest proportion of 71 (17%), followed by Kagera 23 (6%) Tabora 22 (5%), Dodoma 21(5%), Mwanza 19 (5%), Simiyu and Shinyanga 16 (4%), Mtwara and Tanga 15 (4%). Regions with the lowest notification included Mara 4 (1%), Iringa 4 (1%), Unguja 4(1%), Rukwa 3 (1%) and Pemba 1 (0%). The graph below figure 10 shows regional distribution of RR/MDR-TB patients enrolled to treatment.
MDR TB Treatment Outcome
In 2018 409 RR/MDR-TB patients enrolled to treatment among these males were 270 (66%), and 151 (39.6%) patients were HIV coinfected. Paediatric RR/MDR-TB patients were 7 (2%).
Of all 409 patients enrolled to treatment in 2018, 305 (75%) were successfully treated (cured + treatment completed) this is below the target which is 90%.
Those with unfavourable outcome include; 62 (15 %) patients died; 15(4%) patients lost to follow up. A review of trends of enrolment and treatment outcomes from 2009 (figure 11) shows overall increase in number of RR/MDR TB patients enrolled to treatment with average treatment success rate of 77%.
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