文档介绍：MDR management in Syria
Drug management aspects of MDR pilot
MDR TB patients in Syria:
MDR rate (RH resistance) is % among new cases in Syria and around 25-30 MDR-TB patients are expected to develop MDR annually.
( 2003, DRS study in Syria)
Year
Number of patients notified to NTP
2005
12
2006
11
2007
8
MDR patients notified by Governorates
Governorates
2006
2007
Al-raqua
1
1
Aleppo
4
4
Lattakia
1
0
Damascus
1
1
Dier el zor
4
2
Total
11
8
Treating MDR patient in Syria
TB care to MDR patients use to be limited due to the shortage of the second line TB drugs, and the lack of suitable TB beds and MDR management services.
Most of MDR patients used to travel outside the county to Jordan seeking care in Al Mafraq Sanatorium (Massah Al-Nur).
NTP submitted a proposal to GLC for the provision of 2nd line drugs to 35 MDR cases per year for a 3 years period. GLC approved the proposal and training of trainers was conducted.
NTP also started the efforts to build MDR management capacity after GLC approval
The First shipment Arrived in 7-2007
drugs
Quantity
Expire date
Num month /num pat
Kn
3800
1-5-2009
6/21
CM
1080
1-4-2008
1-2-2008
6/6
OFL
45400
1/11/2009
18/21
ET
58400
1/9/2009
18/27
CS
42200
1/11/2008
13/27
PAS
9720
1/1-2/2009
1/11/2008
6/18
Preparing of MDR Units
MOH specified some rooms for treating MDR patients in the intensive phase in the public hospitals in the following governorates:
Aleppo: (Not ready yet because of renovation)
Hums: (ready ?)
Alhassaka: (ready ?)
Drug management cycle
Procurement
Use
Distribution
Selection & Quantification
Management Support
Selection
Selection of drugs is done based on resistance pattern and WHO guideline.
standardized regimen adopted are:
6 Kn- Lf-Cs-Et –Z/18 Lf-Cs-Et for new pat
6 Cm-PAS-Cs-Et /18 PAS-Cs-Et for old
All TB drugs are included in the national essential drug list
The selected drugs are:
- kanamycin 1g
- Ofloxacin 200 mg
- Cycloseri