a home-based approach to managing multi-drug resistant tuberculosis in uganda a case report在乌干达的一个以家庭为基础的方法来管理耐多药结核病病例报告.pdfVIP

Luyirika et al. AIDS Research and Therapy 2012, 9:12 /content/9/1/12 CASE REPORT Open Access A home-based approach to managing multi-drug resistant tuberculosis in Uganda: a case report * Emmanuel Luyirika , Henry Nsobya, Richard Batamwita, Pheona Busingye, William Musoke, Lillian Nabiddo, Yvonne Karamagi and Barbara Mukasa Abstract This case report describes an HIV-positive patient with recurrent tuberculosis in Uganda. After several failed courses of treatment, the patient was diagnosed with multi-drug resistant tuberculosis (MDR-TB). As adequate in-patient facilities were unavailable, we advised the patient to remain at home, and he received treatment at home via his family and a community nurse. The patient had a successful clearance of tuberculosis. This strategy of home-based care represents an important opportunity for treatment of patients in East Africa, where human resource constraints and inadequate hospital facilities exist for complex patients at high risk of infection to others. Keywords: HIV, Tuberculosis, Multi-drug resistant, MDR-TB, Home-care, Home-based care, East Africa, Sub-Saharan Africa Background lung. Investigations showed the sputum ZN smear posi- Successful treatment of multi-drug resistant tuberculosis tive for AFBs (3+). A diagnosis of TB was made, and (MDR-TB) in HIV-positive patients is a challenge in the patient started TB treatment (2RHEZS/1REHZ/ resource-limited settings. In Uganda, the exact magni- 5REH), as per standard guidelines [2]. A sputum sample tude of MDR-TB is not known, though a national drug was sent to the Ugandan National TB laboratory for resistance survey is ongoing. To date, there h