TS MD and Nurses Mechanics
-
Upload
reagan-patriarca -
Category
Documents
-
view
216 -
download
0
Transcript of TS MD and Nurses Mechanics
-
8/2/2019 TS MD and Nurses Mechanics
1/22
Programmatic Management of
Drug-resistant Tuberculosis
PMDT Training for Treatment Site
Physicians & Nurses
Grand Opera Hotel Manila, Sta. Cruz, City of Manila
November 14 - 18, 2011
-
8/2/2019 TS MD and Nurses Mechanics
2/22
PMDT Training for Treatment Site
Physicians & Nurses
BACKGROUND AND MECHANICS
OF THE TRAINING
Grand Opera Hotel Manila, Sta. Cruz, City of Manila
November 14 - 18, 2011
-
8/2/2019 TS MD and Nurses Mechanics
3/22
Definitions
Drug-resistant TB Mono-resistant TB: TB in patients whose
infecting isolates of M. tuberculosis are confirmed
to be resistant in vitro to one first-line anti-TB
drug
Poly-resistant TB: TB in patients whose infecting
isolates are resistant in vitro to more than onefirst-line drug other than both Isoniazid and
Rifampicin
-
8/2/2019 TS MD and Nurses Mechanics
4/22
Definitions
Drug-resistant TB
Multidrug-resistant TB (MDR-TB): is active TB
involving M. tuberculosis organism that areresistant to at least Isoniazid AND Rifampicin,the two most powerful anti-TB agents. AnMDR-TB strain can be resistant to more thanthese two antibiotics.
-
8/2/2019 TS MD and Nurses Mechanics
5/22
Estimated % of New TB
cases with MDR TB
Estimated % of
Retreatment TB cases
with MDR TB
Global 3.4 20
Western Pacific
Region (WPR)
4.9 23
High
MDR TB Burden
Countries
3.8 21
Philippines 4.0 21
Estimated Proportion of TB Cases
that Have MDR - TB
-
8/2/2019 TS MD and Nurses Mechanics
6/22
Estimated Notified Enrolled on
Category IV Tx
Global 290,000 53,108 (18%) 45,553 (85.8%)
WesternPacific
Region
(WPR)
77,000 4,222 (5.4%) 2,210 (52.3%)
HighMDR TB
Burden
Countries
250,000 46,748 (18.6%) 38,652 (82.7%)
Philippines 8,800 522 (5.9%) 548
Number of MDR TB
Estimated, Notified, Enrolled in 2010
-
8/2/2019 TS MD and Nurses Mechanics
7/22
A collective strategy using the different
components of the national TB control
program to effectively manage drug-resistant
tuberculosis.
It include activities on case detection,
treatment, surveillance, monitoring and
evaluation of the programs performance.
What is PMDT?
-
8/2/2019 TS MD and Nurses Mechanics
8/22
Detect & Treat 15,000
MDR-TB Cases by 2016
MDG: To reduce
prevalence and
mortality by half by
the year 2015National TB
Control ProgramCase detection rate: > 85%
Success rate: > 90%
TB in
Adult
TB inChildren
PMDT
TB/HIV
ACSM
PPMD
CATCH TBTB in
Prison
PMDT
2010 2016 Philippine Plan of Action to Control Tuberculosis. Department of Health, Philippines
-
8/2/2019 TS MD and Nurses Mechanics
9/22
Rationale for PMDT
-
8/2/2019 TS MD and Nurses Mechanics
10/22
Rationale for PMDT
-
8/2/2019 TS MD and Nurses Mechanics
11/22
Rationale for PMDT
-
8/2/2019 TS MD and Nurses Mechanics
12/22
MDR-TB Management Framework
5 ELEMENTS OF DOTSTB
Political commitment
Quality assured
microscopy
Supervised treatment
PMDT
Sustained Political commitment
Rational case finding: accurate
& timely diagnosis through
quality assured culture and DST
Appropriate treatment
strategies that utilize 1st and 2nd
line drugs under proper
management conditions
P
-
8/2/2019 TS MD and Nurses Mechanics
13/22
MDR-TB Management Framework
Regular availability of1st line drugs
Standardized records &
reports
Uninterrupted supply of qualityassured 1st and 2nd line drugs
Standardized recording and
reporting system designed for
DR-TB program
5 ELEMENTS OF DOTSTB MDR-TB
-
8/2/2019 TS MD and Nurses Mechanics
14/22
Category IV Treatment
Category IV Treatment is a complex and very
long process that usually lasts from 18 to 24
months
It is critical to ensure that DR-TB patients adhere
to treatment until successful completion
because: DR-TB treatment is the last therapeutic option for
many patients
There is serious public health consequence if
therapy fails
-
8/2/2019 TS MD and Nurses Mechanics
15/22
Main Treatment Center
Hospitals, PPMDs, DOTS
facilities, housing facilities
Satellite Treatment
Center
Hospitals, PPMDs, DOTS
facilities
Treatment Site
PPMDs, DOTS
facilities, NGOs, FBOs
Ambulatory
management of
DR-TB cases atPMDT facilities
-
8/2/2019 TS MD and Nurses Mechanics
16/22
Designed to enable health care staff to provide
quality management of DR-TB cases at the level
of local health facilities as treatment sites.
Treatment site staff eligible for training include
DOTS facility physicians and nurses who will
directly provide management for DR-TB cases. 5-day comprehensive course composed of
modular training with individual and group
exercises and field visits to treatment facilities
PMDT Training of Treatment SitePhysicians & Nurses
-
8/2/2019 TS MD and Nurses Mechanics
17/22
Modules A to G (Day 1
to Day 4)
Module H (Day 5)
Field Visit at Treatment
Center (SPMC)
PMDT Training of Treatment SitePhysicians & Nurses
-
8/2/2019 TS MD and Nurses Mechanics
18/22
SILENT READING to allow participants work
through the modules at their own pace
Facilitators to facilitate pacing of the group,
provide individual or group feedbacks, and
attend to any clarifications, needs, issues, and
concerns
Updates on PMDT will be provided
PMDT Training of Treatment SitePhysicians & Nurses
-
8/2/2019 TS MD and Nurses Mechanics
19/22
Participants satisfactorily completing the course
can already be tapped as treatment partners for
DR-TB patients who would continue category IV
treatment at their respective treatment sites.
After the course, decentralization of DR-TB cases
at their respective treatment sites can already
be arranged at the agreed schedule of the
treatment center staff, ntp coordinator,
treatment site personnel, and of the patient.
PMDT Training of Treatment SitePhysicians & Nurses
-
8/2/2019 TS MD and Nurses Mechanics
20/22
PMDT ExpansionRegion TC STC
NCR LCP PHDU
KASAKA
SLH
PTSI TayumanDJNRMH
Gat Andres MMH
Moonwalk HC
Lagrosa HC
Tondo Forshore HCGracepark HC
Lacson HC
Batasan Hills SHC
1 ITRMC Reg. 1 MC
CAR BGHMC4A DLSHSI; BRH Cainta HC
5 SMMGHHSC Bicol MC
6 WVMC; DPOTMH
7 ECS VSMC
9 ZCMC
10 German Doctors ISI PPMD
11 SPMC DRH
12 KCHO
CARAGA CRH
-
8/2/2019 TS MD and Nurses Mechanics
21/22
Stop the Generation of Drug-resistant TB.
Continue Quality DOTSImplementation and Provide
Diagnosis and Treatment to Patients
with Drug resistance.
-
8/2/2019 TS MD and Nurses Mechanics
22/22
Thank You Very Much!