DRTB Concilium

Zimbabwe remains among the World Health Organization’s (WHO) list of 14 countries that are considered high-burden for TB, MDR-TB as well as TB/HIV co-infection. Zimbabwe ranks 17th among the world’s high TB burden countries, and 4th according to incidence per capita. As of 2018, per 100 000 population, total TB incidence was estimated at 210 (155–272), with an incidence of 130 (96–169) in the HIV positive subgroup. In the same year, 2018, the MDR/RR-TB incidence was 10 (7.4–14) per 100 000 population (WHO, 2018). Also, in 2018, the estimated proportion of TB cases with MDR/RR-TB was 3.9% (3.5–4.3) for new cases and 14% (8.9–20) in previously treated cases. In 2017, treatment success was at 83% for new, relapse and previously treated cases (WHO, 2018). The government of Zimbabwe is committed to ending TB by 2030. By 2025, the National TB Program aims to reduce TB incidence and mortality by 80% (Ministry of Health and Child Care, 2021).

Multi-drug resistant TB (MDR-TB) remains an obstacle to TB elimination. The monitoring of DR TB treatment through national and provincial Conciliums for DR-TB clinical management is an important strategy recommended by World Health Organization (WHO) to end DR TB in the country (D’Ambrosio et al., 2015). By definition, DR-TB Concilium are educational groups to discuss DR-TB case management with senior colleagues knowledgeable about DRTB, with the goal of minimizing the loss of new drug effectiveness through inexperience and repetitive basic errors. Tiberi et al (2019) outline the origin and operations of DRTB Conciliums. TB Conciliums act as gatekeepers to the new drugs, monitor guideline adherence and manage drug safety. This TCG seeks to operationalize the national and provincial Conciliums for DR-TB clinical management across all DR facilities in four priority provinces with the worst performing DRTB indicators.