TB Epidemic in Tajikistan

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TB Epidemic in Tajikistan
ALI BUZURUKOV BU School of Public Health bjali_at_bu
.edu
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Pamir highest mountains of former USSR
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TajikistanCountry Background

• Former Soviet Union Republic in Central Asia
• Total population 6.O66 million
• Approximately the size of Wisconsin 143,100 km2
  
  
• Landlocked Mountainous country

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Country Socioeconomic Background

• GNP 360
• 80 below poverty line
• Mostly rural population 72
• 44 under age 15
• 98.6 literacy rate
• Pop. Growth 1.7

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COUNTRY HEALTH INDICATORS

• Infant mortality rate 57/1,000
• Maternal mortality rate 130/100,000
• Life expectancy at birth 68.3 years
• 19.4 doctors per 1000 patients

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Allocations for Health
Source State Statistical Agency, HDR 1998
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TB services
Free treatment Two TB centers 59 regional di
spensaries Two Republican complex hospitals Four
regional hospitals
One Children hospital
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Factors contributing to TB Epidemic

• Collapse of health care system
• Civil war and huge migration processes
• Poor treatment diagnosis
• Brain drain of Medical personal
• Drug supply at 10
• No reliable statistics

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TB Mortality and Incidence Rates in Tajikistan
(MOH)
WHO Estimate 267/100,000
Ahad Fazelad
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Reported Cases of TB 1980-1998 (MOH)
Notification
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Tajikistan does not even have pilot areas under
DOTS- you can be sure they have NO idea of the
extent MDR TB

• Quote from Ian Small, Head of Mission, Médecins
  Sans Frontières, The Aral Sea Program

With the collapse of Soviet health care system,
infectious diseases outbreaks have become
frequent, especially in rural areas.
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Children and TB

• 20 Extra-pulmonary TB 30 in Children
• Only TB Children hospital for 96 beds
• Street Children

Orphan girl standing in front of her destroyed
home
http//benevolence.org
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Children TB Hospital in Dushanbe financed by poor
state budget
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(No Transcript)
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What is to be done?

• Government commitment to sustain
• TB control
• Sputum smear microscopy to detect infectious
  cases
  
• Standardized short-course treatment regimen with
  direct observation
  
• Regular, uninterrupted drug supply
• Monitoring and reporting system

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Need for International aid

• TB drugs
• DOTS promotion
• Research
• Partnership