Extensive review of tuberculosis prevention, control and care in Kazakhstan
The notification rate of TB cases in Kazakhstan is among the highest in the WHO European Region. WHO was requested to organize a review of the Kazakh Tuberculosis Programme, which took place from 10 to 16 May 2012.
The reviewers made a number of recommendations to improve the programme. The main focus should be on: expansion of the programmatic management of drug-resistant TB, introduction and roll-out of molecular diagnosis of TB and MDR-TB, expansion of ambulatory treatment of patients, and home-based care and day-care treatment including all eligible patients, particularly sputum-smearnegative patients (as well as sputum-smear-negative MDR-TB patients).
Hospitalization practices need to be rationalized in order:
(i) to prevent the spread of drug resistance, and
(ii) to use the available resources more efficiently by reallocating the funds saved by reducing the number of hospitals to expand ambulatory treatment, social support for patients and the number of health-care providers.
Examples of the involvement of civil society organizations and provision of an integrated continuum of care (transfer of released patients from prison to civilian sector) need to be expanded across the country.