PARIS 2008: Mix of clinical and home-based TB approaches pays off in Cambodia

Photo by jonathanb1989A mixture of clinical and home-based care approaches has improved tuberculosis (TB) responses in Cambodia, according to Dr Sok Thim of the Cambodian Health Committee (CHC).

The prognosis for patients treated for TB at home was much better than the prognosis of those treated in hospital and people treated for the disease at home recorded faster rates of recovery, Dr Thim told delegates at the 39th World Conference on Lung Health in Paris.

He also said that people treated for the disease at home reported no supra-bacterial or secondary infections while high numbers of people treated at clinics did contract further health problems.

Cambodia is ranked 21 on a list of 22 high TB-burdened countries and has a TB detection rate of 65.4%. About 85% of those diagnosed with TB in the country are reported successfully cured while according to the CHC, 75% of cases are detected, 95% of which are successfully treated.

Cambodia has also reported more than 100 cases of suspected multi-drug-resistant TB (MDR-TB) but the real number of cases could be as much as three time higher. About 1.6% of new TB cases in the country are believed to involve MDR-TB while a number of extensively drug-resistant TB (XDR-TB) cases have also been reported.

“It is quite possible that among relapsed TB cases or those who failed TB treatment, the percentage of MDR-TB is 2-3 times higher,” Dr Thim told delegates.

With the support of private donors, the CHC and its partner the National TB Program are treating the confirmed MDR-TB cases but about eight of the 79 people known to have the disease died before their status was confirmed. WHO has now approved an application by the CHC for low-cost high-quality drugs to treat an additional 100 MDR-TB positive people.

The management of MDR-TB is particularly difficult in resource-poor settings such as Cambodia but the CHC is working on infection control measures and the training of medical personnel.

Bobby Ramakant-CNS

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