Medical and legal aspects of the activities of the Committee on the management of drug-resistant tuberculosis

Abstract

Purpose. To highlight the medical and legal aspects of the activities of the Committee on Management (CM) of drug-resistant tuberculosis (DR-TB). Materials and methods. Analysis of reports on the work of the CM and regulations governing its activities. Results. TB DR remains a problem in many national health services (NHAs). In recent years, in the Republic of Moldova, its share has been about ¼ among all new cases and ½ among all cases of retreatment. In this regard, CM is an important element in the quality assurance system for TB DR management. In 2020, by decision of the CM, 536 patients were included in the TB DR treatment program. In their structure, new patients accounted for 43.5%, patients with relapse - 25.2%, patients after ineffective treatment - 16.4%, and patients from among those previously lost to follow-up - 14.9%. Decisions on the place and mode of chemotherapy, treatment adjustment and assessment of its effectiveness (ET) were made by the CM based on clinical judgment, taking into account the data of DR testing, the history of previous treatment, the severity and localization of TB etc. The above ensured the management of patients according to the recommendations of the National Clinical Protocol and the WHO Consolidated Guidelines for the Treatment of TB DR. The experience of the NHA accumulated in recent years in the use of information and communication technologies (teleconsultations „doctordoctor” etc.) allowed the NCM in the context of the COVID-19 pandemic to hold meetings online. Conclusion. CM is an important element in the system of quality assurance of TB DR management, which uses modern medical standards and information technologies in its activities, respects the rights and legitimate interests of patients.