• Course information

    Place of training
    Cape Town, South Africa
    Target group
    Medical coordinators, medical doctors, clinical officers and nurses in programmatic and/or clinical key roles with regard to DR-TB management
    Number of participants
    25 maximum
    5.5 days

    All applications should be sent to your pool manager/L&D unit then before 5th October 2018 to the SAMU Learning Unit administrator: cindy.cordingley-wiid@joburg.msf.org

    24 - 29 November 2019 | 23 - 27 November 2020
  • Background

    Drug-resistant TB (DR-TB) is a recognized threat throughout the world and occupies an increasing priority role in MSF operations. 

    The introduction and roll out of rapid tests for TB and drug-resistance detection are improving the early diagnosis of TB/DRTB, including among patients co-infected with HIV.  New drugs have been approved for use in MDR and XDRTB patients, and in 2016 new WHO recommendations on the use of a shorter DRTB regimen have been released.  MSF, in collaboration with MoH counterparts, is one of the main actors worldwide introducing and scaling up the access to these new drugs and new regime, while advocating for shorter, more effective and less toxic treatments.  Several clinical trials, aiming to find better treatments for DRTB, are ongoing or in the pipeline, including two MSF-driven initiatives.

    Models of care and adherence strategies for DRTB continue to evolve, and management of DR TB patients through decentralised ambulatory and even community based treatment models have been demonstrated as cost-effective.

    Despite all this, countries and projects keep experiencing relevant challenges in the clinical and programmatic management of DRTB and we need to ensure that health care workers build the skills to respond to the increasing DR-TB needs and challenges, including the management of patients co-infected with HIV and correct use of new drugs. 

    The project of Khayelitsha, in Cape Town, is one of the first MSF projects addressing the epidemics of DRTB and the challenges of co-infection with HIV, and throughout the years, the project has implemented new strategies for early detection and management of DRTB, piloting an integrated and decentralised model of care, which contributed to changes in national policies.

    This training aims to improve the programmatic and clinical knowledge related to management of DR-TB in MoH and MSF health care workers from a variety of settings supported by all MSF Operational Centres.

    Target Group

    • Medical coordinators, medical doctors, clinical officers and nurses in programmatic and/or clinical key roles with regard to DR-TB management
    • Ministry of Health representatives, associated with an MSF project, are welcome to attend when participating together with an MSF staff member of the respective project
    • Representatives from headquarters (HQ) will also be invited (e.g. medical polyvalent)

    Note: Since learning can also be a reflective process on actual and past experiences, we encourage participants to attend this training only when they are already working in the position. Under these circumstances real transfer happens, namely the application of acquired knowledge that impacts performance in the workplace.

  • Objectives

    General Objective:

    • To contribute to the provision of quality DR-TB clinical care within a resource-limited context

    Intermediate Objectives:

    • Increase knowledge related to programmatic and clinical management of DR-TB in resource-limited settings
    • Share practical experience amongst participants, especially related to the most challenging aspects of DR-TB management
    • Review different models of DR-TB care (e.g. urban vs. rural), with a focus on ambulatory/community-based models
  • Content

    • Comprehensively cover issues related to DR-TB (and to a lesser extent, drug-sensitive TB) including epidemiology, prevention, diagnostic procedures, treatment including new drugs and new regimens, management of adverse events, M&E.
    • Selected topics to be run in 2 branches: clinical (80%) and programmatic (20%)
    • Focus on new diagnostic tools, new TB drugs and regimens for MDR and XDR TB
    • Site visits to Khayelitsha to show decentralised, ambulatory and community-based DR-TB management, including by nurses. In Ubuntu clinic, Lizo Nobanda hospice & Town Two clinic
  • Facilitators and Methodology

    Collaborating partners

    • MSF Khayelitsha
    • Other OCs, Local/MoH partners

    Pedagogic Approach
    The group as a peer to peer source of learning and exchange, and the presenters as learning facilitators are the important pillars of the proposed method.

    • Presentations by local or external experts
    • Interactive methodology, clinical case studies
    • Group and individual work.
    • Experience sharing by participants