RESEARCH ARTICLE


Role of Technical Assistance in the Establishment and Scale Up of Programmatic Management of Drug Resistant Tuberculosis (PMDT) in Ethiopia



Ezra Shimeles*, 1, Getachew Wondimagegn1, Ahmed Bedru1, Addisalem Yilma1, Dawit Assefa1, Tesfaye Abicho1, Ermias Diro2, Yasmin Hashim3, Victor Ombeka4, Rene L'Herminez5, Eveline Klinkenberg5, 6
1 KNCV Tuberculosis Foundation, TBCARE I, Addis Ababa, Ethiopia
2 Gondar University Hospital, Gondar, Ethiopia
3 ALERT Center, Addis Ababa, Ethiopia
4 KNCV Tuberculosis Foundation, Africa regional office, Nairobi, Kenya
5 KNCV Tuberculosis Foundation, Central Office, The Hague, The Netherlands
6 Department of Global Health, Academic Medical Center, University of Amsterdam, Amsterdam Institute for Global Health and Development, The Netherlands

Article Information


Identifiers and Pagination:

Year: 2013
Volume: 7
First Page: 30
Last Page: 35
Publisher Id: TOIDJ-7-30
DOI: 10.2174/1874279301307010030

Article History:

Received Date: 17/12/2012
Revision Received Date: 15/2/2013
Acceptance Date: 17/2/2013
Electronic publication date: 19/4/2013
Collection year: 2013

© 2013 Shimeles et al.

open-access license: This is an open access article distributed under the terms of the Creative Commons Attribution 4.0 International Public License (CC-BY 4.0), a copy of which is available at: https://creativecommons.org/licenses/by/4.0/legalcode. This license permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.

Correspondence: * Address correspondence to this author at the KNCV Tuberculosis Foundation, TBCARE I, Addis Ababa, Ethiopia. Tel: +251 116632362; Fax: +251 116 632362; E-mail: shimelese@kncvtbc.nl


Abstract

Implementation and scale up of programmatic management of drug resistant tuberculosis (PMDT) has proven to be a challenge in many resource-constrained settings like in Ethiopia, despite the political commitment.

A critical programmatic gap analysis was conducted by technical experts to develop feasible recommendations for incorporating multi drug resistant tuberculosis (MDR-TB) management in the national TB program following international guidelines and receiving continuous technical and financial support.

The major achievement was building of technical capacity in the country at the level of a national MDR-TB technical working group (TWG) as well as at the level of the MDR-TB treatment hospitals among the MDR management teams. In addition, guideline development, improved access to second line drugs and renovation of health facilities in accordance with TB infection control standards contributed to optimize implementation. Between February 2009 and September 2012, 575 MDR-TB patients accessed treatment under the program.

Building programmatic and clinical capacity at different levels of the health system in combination with strong political commitment and partner's engagement were key elements of the PMDT approach. Structured technical assistance combined with financial support during key steps was critical in the initiation and subsequent scale up of the program.

Keywords: Ethiopia, MDR-TB, PMDT.