Le Nouveau Sans Frontieres 1 Audio Free Download

Ambulatory level care for MDR/RR-TB patients is provided in approximately 60 primary healthcare centres, which have separate consultation rooms for TB care. Health personnel specialised in TB, including phtysiologists (TB physicians), nurses, social workers and counsellors, provide TB care. In Armenia, as in many post-Soviet countries, TB and HCV were considered two separate disciplines and managed by different specialists. The country is divided into 11 provinces with Yerevan, the capital, considered as an additional separate administrative unit. We describe the implementation and healthcare worker and patient perspectives of the Armenian integrated treatment model of care.Īrmenia is an upper middle-income country with a population of around 3 million. 9 However, to our knowledge the evaluation of an integrated HCV and MDR/RR-TB treatment model has not been reported elsewhere. The safety and efficacy of concomitant HCV and MDR/RR-TB treatment in Armenia has been previously reported. The Armenian Ministry of Health (MoH), with the support of Médecins Sans Frontières (MSF), introduced systematic HCV testing for MDR/RR-TB patients and treatment with DAAs (which, until this time, were largely unavailable) for MDR/RR-TB patients with chronic HCV. 8 There was an overall lack of HCV treatment, and interferon analogues were the only treatment options available to patients.ĭuring 2016–2018, a model of care integrating chronic HCV diagnosis and treatment for MDR/RR-TB patients was introduced in the country. Diagnostic confirmation of HCV was not funded by the state, and there was no national protocol to treat HCV. 1 Prior to 2016 MDR/RR-TB patients in Armenia were not systematically tested for HCV infection and the prevalence of HCV among MDR/RR-TB patients was unknown. 7 However, despite existing effective treatment for HCV, DAAs are not widely used for patients with MDR/RR-TB.Īrmenia has a high MDR/RR-TB incidence (5.8 per 100,000 people). introduction of direct-acting antivirals (DAA) has transformed the treatment landscape for chronic HCV. 3 Drug-induced liver injury (DILI) is one of the most common adverse events during MDR/RR-TB treatment, 4 – 6 and is more likely to develop in MDR/RR-TB patients co-infected with HCV. 1, 2 The prevalence of HCV infection among MDR/RR-TB patients has been reported to be 12% in a multi-country study. The twin epidemics of multidrug or rifampicin-resistant TB (MDR/RR-TB) and hepatitis C virus (HCV) infections have led to almost half a million cases of MDR/RR-TB yearly and 71 million people living with HCV.

Le Nouveau Sans Frontieres 1 Audio Free Download