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Naypyidaw, Myamar, 31 October 2016 – With multi-drug resistant (MDR) tuberculosis on the rise in Myanmar, 3MDG partners are using data to track patient progress, identify gaps in health service provision and highlight disease hot spots.
Treatment of MDR-TB, a form of tuberculosis resistant to the drugs normally used to treat it, is long and debilitating for patients, and intensive for healthcare workers, who must make multiple daily visits to administer treatment.
Making sure patients stick to the 20 month treatment course and there are enough staff for this work can be challenging, but is necessary to halt the spread of this deadly disease.
Dr. Khin Swe Win, a programme co-ordinator with Myanmar Medical Association (MMA), is familiar with some of the obstacles, such as losing contact with patients or treatment dropout, having worked with MDR-TB for many years.
“With a paper-based system, it can also be hard to keep track of where patients are in their treatment and to collect detailed information on them, which increases the workload of health staff. It is difficult to get a picture of where the cases are, and where we need to have resources.”
With WHO estimating 9,000 new cases of MDR-TB in Myanmar each year, it is critical to have an overview of the disease. The National TB Programme (NTP) has begun to record and analyze data, including numbers of newly enrolled patients and where patients are located. This is beneficial for planning and co-ordination of services, tracking patient progress and helping patients navigate and better understand the effects of MDR-TB and its treatment.
3MDG partners submit information monthly, focusing on improvements that have been made, issues that are faced, and lessons and good practices that have been learned. Data is gathered during implementation, through monitoring reports and via routine health information systems. Each partner also regularly uses MDR-TB reporting templates.
Dr. Khin Swe Win, can already see a big difference. “Now, we can analyze rates of cure and mortality for patients who receive treatment, and looking even bigger, we can analyze the whole MDR-TB situation in Yangon and Mandalay regions.”
U Thant Zaw Zaw, project manager of Myanmar Health Assistant Association (MMA) also acknowledges the effectiveness of the template. “Before, we only recorded data quarterly and submitted it biannually. That meant that if there were any missed patients, or errors, it was discovered too late. Now we can assess and analyze what we are facing, and how we are going, every month,” he said.
The latest data collected for MDR-TB shows impressive results. In Yangon, out of 1,648 patients, only nine have dropped out of the treatment programme; meaning the vast majority of patients that have been diagnosed with MDR-TB are receiving the care they need. For those that drop out, health care providers can conduct further follow ups to find out why, and encourage them to continue treatment.
An even clearer overview will soon be possible with the introduction of an electronic database being developed by the Clinton Health Access Initiative and the NTP. Financed by 3MDG, the database will focus on supporting MDR-TB patient case management at key health facility level and overall enrolment and management at the national level. With these collective and persistent efforts, and the use of data to inform disease responses, the spread of MDR-TB can hopefully be halted on a national scale.