title: Challenges and solutions to implementing drug-resistant tuberculosis programmes for children in Central Asia.
abstract: Guidelines for children with drug-resistant tuberculosis (DR-TB) tend to focus on individual patient care; there is little guidance for national tuberculosis programmes (NTPs) on how to plan, implement and integrate DR-TB services for children. In 2013, through the paediatric tuberculosis (TB) programme started by the Tajikistan Ministry of Health and Médecins Sans Frontières in 2011, 21 children became the first to be treated for multidrug-resistant tuberculosis (MDR-TB) in Tajikistan. We describe the challenges encountered in establishing the programme and the solutions to these challenges, and propose a framework to guide the implementation of paediatric DR-TB care. This framework could prove useful for other NTPs in resource-limited settings.
authors.affiliation: Manson Unit, Médecins Sans Frontières (MSF), London, UK.
authors.forename: P
authors.initials: P
authors.lastname: du Cros
authors.affiliation: MSF, Dushanbe, Tajikistan.
authors.forename: A
authors.initials: A
authors.lastname: Swaminathan
authors.affiliation: Ministry of Health and Social Protection of Population, Dushanbe, Tajikistan.
authors.forename: O I
authors.initials: OI
authors.lastname: Bobokhojaev
authors.affiliation: Ministry of Health and Social Protection of Population, Dushanbe, Tajikistan.
authors.forename: Z D
authors.initials: ZD
authors.lastname: Sharifovna
authors.affiliation: MSF, Dushanbe, Tajikistan.
authors.forename: C
authors.initials: C
authors.lastname: Martin
authors.affiliation: Manson Unit, Médecins Sans Frontières (MSF), London, UK.
authors.forename: K
authors.initials: K
authors.lastname: Herboczek
authors.affiliation: MSF, Dushanbe, Tajikistan.
authors.forename: C
authors.initials: C
authors.lastname: Höhn
authors.affiliation: Manson Unit, Médecins Sans Frontières (MSF), London, UK ; Department of Paediatrics, Imperial College, London, UK.
authors.forename: J A
authors.initials: JA
authors.lastname: Seddon
keywords: DR-TB; Tajikistan; paediatric