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The USAID Eliminating Tuberculosis in Central Asia activity uses state-of-the-art information technology (IT) equipment to virtually train TB specialists at the National Reference Laboratory in Kazakhstan. 

From January-March 2021, in partnership with the Kazakhstan National Scientific Center of Phthisiopulmonology, USAID remotely trained 38 specialists in 19 laboratories across the country. Over their video screens and with cameras in hand, trainees have learned how to test biological samples from TB patients to determine whether they are resistant to any of the commonly-used TB medications. Results of this type of drug susceptibility testing let prescribing physicians know which drugs will be effective or ineffective in treating a specific patient and are therefore key to ensuring patients are prescribed the treatment they need. 

Over the past 20 years, Kazakhstan’s National TB Program has successfully decreased TB incidence by more than 60% and reduced mortality sixfold. Despite these successes, however, Kazakhstan is still among the 30 countries with the highest drug-resistant (DR) TB burden. One of the top ten causes of death globally, DR-TB results when a patient is infected with TB bacteria that has developed resistance to one or more of the drugs used to treat the disease.  

In 2018, Kazakhstan introduced a set of drugs newly-approved by the World Health Organization for treatment of DR-TB. Drug susceptibility testing for these new medications was unavailable when the drugs were first introduced. In fact, drug susceptibility testing for the new medications was just being rolled out in Kazakhstan when pandemic restrictions were introduced across Kazakhstan. 

“USAID promoted the introduction of DR-TB diagnostics. This helps to detect and start quality treatment of DR-TB in a timely manner, which will meet the overall goal of eliminating tuberculosis throughout the country,” Lyailya said.

ADAPTING TO COVID-19 WITH VIRTUAL TRAINING

Thanks to the interactive virtual training methods introduced by USAID, the National TB Program has been able to continue its rollout of this crucial testing. The shift to online training has ensured that Lyailya and her colleagues in the lab, as well as doctors and nurses, remain up-to-date on the latest prevention, diagnosis, and treatment protocols, meaning that the correct TB drugs and services reach patients. To support the National TB Program’s continued virtual training as the COVID pandemic restricted in-person training, USAID purchased and installed equipment in the National TB laboratory, including cameras and tablets. 

To ensure top-quality training on drug susceptibility testing, USAID also coordinated with experts from the Supranational Reference Laboratory in Gauting, Germany, to conduct synchronous training for laboratory staff. Using high-quality portable action cameras, trainers in Germany were able to observe the performance of their trainees in real-time as they conducted sample tests. Even from afar, the trainers could quickly identify issues and advise the lab specialists on how to fix errors. The experts from Germany also provided remote mentoring and consulting assistance after the training course.

“If there is a problem, one can use this equipment and record a training video on a specific procedure. The recorded video can be sent to the specialist in another location who can view it and fix the problem. The use of such high-tech tools has tremendous advantages for conducting online training, consultations, especially in the conditions of quarantine restrictions,” Lyailya explains.

COUNTRYWIDE SUPPORT

Lyailya and some of her colleagues are now conducting training remotely for laboratory specialists throughout Kazakhstan. “Thanks to these trainings, we will be able to detect drug-resistant tuberculosis in time and give patients a chance to be properly treated,” noted Ainur Eleusizova, a recent trainee who heads the Bacteriological Laboratory of the TB Phthisiopulmonology Center in Almaty. In total, 52 lab specialists - nearly 26 percent of the country’s specialists - have been trained on accurate drug susceptibility testing. 

Through capacity building efforts such as this, USAID works alongside the Government of Kazakhstan to strengthen the laboratory system to improve TB diagnostics, facilitate quicker enrollment of patients on appropriate treatment, and ensure more successful TB treatment outcomes for patients across the country.

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Ляйля, ТБ Специалист