Note to the participants
Welcome to the new course on the Drug-Resistant Tuberculosis Management in Rwanda.
New drug-resistant tuberculosis (DR-TB) diagnostic tools and/or drugs are coming in everyday and DR-TB guidelines are frequently updated.
Consequently clinicians deployed at the different levels of health facilities mainly those in MDR-TB treatment initiating centres require trainings in the use of these new diagnostic tools and the interpretation of new guidelines.Therefore the TB&ORD Division in collaboration with partners has developed an online training on “Drug-Resistant Tuberculosis Management in Rwanda”.
The target group for this training is the clinical staff involved in the management of TB at different levels of health system in Rwanda: it includes nurses and medical doctors. The facilitators are mainly the staff from TB-ORD divisions of RBC.
This training will provide the participants with the appropriate tools to manage a patient holistically in all aspects of DR-TB. It includes epidemiological status of the disease, clinical aspects of DR-TB diagnosis and care, recording and reporting, etc.
Its general objective is to integrate the management of DR-TB into the routine activities of the TB control program at the decentralized level and establish an effective monitoring and evaluation system. It has three specific objectives:
- To improve participants' knowledge on drug resistant tuberculosis management
- To extend the DR-TB management capacity at the peripheral health facilities
- To strengthen the quality of care for DR-TB at peripheral health facilities.
The course has 10 chapters:
- In the 1st chapter, participants will be introduced to the epidemiology of DR-TB in the world and in Rwanda and a brief history of DR-TB management in Rwanda will be given. Moreover participants will learn important definitions used in DR-TB management, introduced to the causes of DR-TB and different ways of preventing the disease.
- The 2nd chapter will talk about different methods of diagnosing TB and DR-TB in Rwanda and the correct interpretation of their results.
- Chapter three will present different options for DR-TB treatment, selection criteria for treatment (shorter/longer) regimens and treatment follow-up plans will be presented. Moreover DR-TB rescue treatment designing principles will be discussed in this chapter.
- During the 4th chapter, participants will be introduced on different HIV and DR-TB collaborative activities. Attention will be made on the management of co-infection of DR-TB with HIV including drug-drug interactions.
- Chapter 5 will discuss DR-TB patients management in some special situations including pregnancy and breastfeeding, contraception, childhood, diabetes mellitus, renal failure, etc.
- Methods of contacts tracing and different options of preventive therapy for DR-TB close contacts will be discussed in chapter 6 of this course.
- Chapter 7 will introduce participants to the active drug safety monitoring and management concepts. We will emphasize on early detection and proper management of common adverse effects in DR-TB management.
- DR-TB patients are provided with psycho-social and financial support throughout the duration of treatment. During chapter 8, participants of this course will be introduced on different forms of patient support currently available for DR-TB patients in Rwanda.
- TB infection prevention and control is an important component of the fight against tuberculosis. Chapter 9 of this course will teach participants different groups of infection prevention and control measures including managerial and administrative measures, environmental measures and personal respiratory protection equipment.
- The last but not the least chapter, chapter 10, will describe the information system for patients that fall under PMDT in Rwanda, with the objective of recording information needed to monitor PMDT performance through TB drug resistance notifications and treatment outcomes.
Upon completion of this practical training, health care providers will be equipped with up-to-date knowledge on drug resistance and program standards, and will be able to:
- Explain the epidemiology of DR-TB in the world and in Rwanda
- Identify patients with presumption of DR-TB disease,
- Request recommended TB diagnostic tests and correctly interpret test results
- Prescribe and correctly monitor the 2nd line TB treatment
- Recognise the side effects of 2nd line TB treatment and ensure their management
- Provide psychosocial support to patients under DR-TB treatment
- Monitor DR-TB in special situations (HIV, children, diabetics, etc.)
- Conduct the DR-TB contacts tracing in the community
- Understand and implement basic measures of TB infection control at health facility
- Correctly record and timely report DR-TB data.
The training consists of a five-day course (8 hours/day) evaluated by a post-test. To get the certificate of completion of the training the participant should pass the training post evaluation with at least 80%.
We welcome you again to this course on Drug-Resistant Tuberculosis Management in Rwanda.
We wish you pleasant learning.
Tuberculosis (TB) is a communicable disease that is one of the top 10 causes of death worldwide and the leading cause of death from a single infectious agent. With a timely diagnosis and treatment with first-line antibiotics for 6 months, most people who develop TB can be cured and onward transmission of infection curtailed. The number of TB cases occurring each year (and thus the number of TB-related deaths) can also be driven down by reducing the prevalence of health-related risk factors for TB, providing preventive treatment in specific risk groups, and taking multisectoral action on broader determinants of TB infection and disease such as poverty, housing quality and undernutrition. As a member of the World Health Assembly, Rwanda endorsed the END TB strategy which is aligned with the Sustainable Development Goals (SDGs) and aims to end the global TB epidemic by 2035 by markedly reducing death and incidence and eliminating the social and economic burden of the disease.
Description of the course
This module will provide the theoretical knowledge and skills that health workers specifically need to understand the epidemiology of TB and strategies to end the global TB epidemic, diagnose people with TB, effectively treat drug-susceptible TB in adults and children, including HIV-infected patients, prevent the disease and educate patients and communities about TB.