Viet Nam has seen encouraging results in dealing with multidrug-resistant TB (MDR-TB) as this feature on one young woman from northern Viet Nam shows.
“The pain in my upper back came first, then it became hard to breathe and my chest hurt,” says Thanh, a 24-year-old wife and mother, as she describes her early symptoms of tuberculosis.
She was diagnosed last year at the community health post near her farm in northern Viet Nam, and started taking medicines right away. But after eight months of taking anti-TB drugs, her health did not improve. The medicines were not working and she began to lose hope of being cured.
Then her doctor sent her to Hanoi Lung Hospital, 35km away, where a newly refurbished unit handles suspect cases of multidrug-resistant TB (MDR-TB). Two months later, Thanh is responding well to treatment and she is optimistic about returning home to finish the 18-24 month course of treatment with her husband as caregiver.
Resistance to anti-TB drugs
MDR-TB is a potentially deadly, hard-to-treat form of TB that is resistant to the most powerful TB drugs, isoniazid and rifampicin. Resistance to anti-TB drugs can occur when doctors do not prescribe appropriate treatment regimens or when patients misuse or mismanage anti-TB drugs, for example by not completing the full treatment. It can also occur if medicines are of poor quality.
Investing in health services to control MDR-TB
Viet Nam is one of 27 countries globally with a high burden of MDR-TB.
“Viet Nam is committed to fighting TB and its treatment success rate is consistently high – exceeding 90% for reported cases,” says Dr Takeshi Kasai, the WHO Representative in the country.
“But the continuing spread of MDR-TB could change all that. If we don’t invest in health services at every level to face the challenge of drug resistance, we will have a much bigger problem to cope with later,” he says.
Step by step, Viet Nam is establishing gold-standard laboratory, clinical, drug procurement, planning and monitoring services to better assess and control MDR-TB.
“It has taken four years to get the technical capacity, facilities and funding in place to roll out services, and we are now seeing results in places such as the Hanoi Lung Hospital,” says Dr Cornelia Hennig, from WHO’s Stop TB Department in Hanoi.
Installation of a new diagnostic device that can test patients for TB and rifampicin resistance in just 100 minutes (known as Xpert MTB/RIF) is a “qualitative leap forward,” says Hennig.