Locating people most at-risk for developing tuberculosis.

	Laboratory in Strezhevoy tests for HIV and MDR-TB.
	Nurse drawing blood from an HIV-positive patient in Strezhevoy.

Recently, PIH-Russia strengthened its proactive tuberculosis program in Strezhevoy, a town of 45,000 people located about 400 miles north of PIH’s first Russian program in Tomsk City. Isolated by hundreds of miles of tundra, the town is defined by its Siberian culture, the large oil-based production companies that employ much of the city’s workforce, and one of highest incidence rate for HIV and co-infection of tuberculosis HIV and tuberculosis (TB) in that region of Russia. Making matters worse, a disproportionate number of people are developing multidrug-resistant TB (MDR-TB).

Nationwide, Russia reports 85.1 cases of TB for every 100,000 people, compared to only five per 100,000 in the United States. In Tomsk Oblast, where Strezhevoy is located, the number tops 101.5 new cases per 100,000. Additionally, about 13 percent of new TB cases are MDR-TB in Tomsk Oblast. Moreover, curbing the rate of TB in regions like Strezhevoy has been difficult, due in part a high rate of intravenous drug use and its isolation.

In order to reverse these trends, PIH-Russia refined an algorithm used to identify HIV patients who are most at risk of contracting TB. A preventive strike against TB and MDR-TB.

The team used information collected and analyzed over the past decade to create the algorithm. The formula relies on the results of the TB testing, patients’ CD4 count, their exposure to TB, and other factors.

Once identified using the formula, the patients are put on an intense anti-TB drug regimen called Latent TB Infection (LTBI) chemoprophylaxis. They will take the drugs for four months, three times a week, under the direct observation of medical staff. To encourage patients to take care of themselves while on the regimen, they receive food packages during the course of treatment.

If a patient is not able to visit the nearest treatment facility, PIH medical workers will visit the patient in their home as part of the organization’s “Hospital at Home” project.

The goal: prevent people from contracting a disease that is often painful, and for people living with HIV, deadly.

Preventing the spread of TB not only spares the patient, but also reduces the threat of transmitting the disease within the larger community.

Read more about PIH’s work in Russia.