“Marius Nasta” Institute of Pneumology, supported by RAA Foundation, proposes an average hospitalization period for the MDR- TB patients of 120 days.
21th of February, 2008
One of the most significant results of Round 2 projects is the inauguration, in 2004 and 2005, of two Multi-Drog Resistant (MDR-TB) diagnostic and treatment centers. Those two centers are opened in Bucharest (in "Marius Nasta" Pneumophtisiology Institute) and at Bisericani (Neamt County), with a total number of 130 beds.
In the past years, MDR-TB has become an extremely serious issue for the global TB control, due to its diagnosis and treatment difficulties.
MDR-TB cases are resistant at least to Izonizide and Riphampicine , the major two drugs for TB treatment. Patients with this TB form are treated with second line TB drugs, much more expensive and hardly tolerated, for a much longer period (between 18 to 24 months, in comparison with 6 to 8 months for the treatment of an usual TB patient) and with less significant therapeutically results ( therapeutically success rate of 60% in comparison with 85%).
As a plus it requires special measures: bacteriological diagnosis in a laboratory with systematically external quality control for drug susceptibility / resistance for M. Tuberculosis, special measures for airborne infection control, management of the treatment side effects, surgical treatment associated, education of the patients and insurance of the necessary psychological support.
The costs for the care of those patients, witch include costs related to diagnosis, treatment and hospitalization are much higher than those for the diagnosis and treatment for usual TB patients.
In order to insure diagnosis and treatment and to reach a higher successful therapeutically rate, in the conditions of respecting the international standards, it is necessary the insurance of appropriate financial resources for running those two centers. It is possible to reach this through payment of appropriate number of hospitalization days.
According to the last Drug Resistant Survey performed in Romania in 2003-2004, aprox. 3% of new cases and 10% of previously TB treated cases are MDR-TB. If we apply the figures to an average number of 20,000 new cases and 5,000 retreated cases that are registered annually in Romania, we would expect to register annually over 1,000 MDR-TB cases.
View the situation that there are tested for drug susceptibility aprox. 20% of new cases and 40% of previously treated cases, there are registered annually aprox. 400 MDR-TB cases.
One of the project planned to be implemented during Global Fund's 6th Round by the "Marius Nasta" Institute of Pneumophtisiology is meant to extend the MDR-TB control, by implementing DOTS-Plus Project. This project will include a new cohort of at least 160 patients with MDR-TB in treatment in those 2 centers and insuring the TB drugs for those patients from international suppliers.
Taking into consideration the above mentioned issues, RAA Foundation has sent a Memo to the Ministry of Public Health ( Public Health Authority and National Agency for Health Programs) and also to the National Health Insurance House (NHIH).
The purpose of this Memo is to support the approaches done by "Marius Nasta" Institute of Pneumophtisiology and the Central Management Department of NTP, referring to re-considering and approval an optimal average length of the hospitalization for MDR-TB patients to at least 120 days for MDR-TB patients hospitalized in Bucharest and Bisericani centers.
Click here to read the English translated Memo sent by RAA Foundation.
