Ukraine has updated the standards of medical care for tuberculosis

Ukraine was the first country in the European region to bring national health standards in the case of tuberculosis in line with WHO recommendations 2022. On 19 January 2023, the Order of the Ministry of Health of Ukraine No. 102 approved the standards of medical care “Tuberculosis”. The standards were developed with the active participation of specialists from the Center for Public Health.

These standards are aimed at improving the regulatory framework on evidence-based medicine and WHO recommendations. They will improve the quality of treatment, reduce morbidity, disability, and mortality, as well as reduce costs and risks for patients.

“We continue to work for the health of Ukrainians. New standards of medical care for tuberculosis will make it possible to counteract the disease more effectively. Their main goal is to recover for patients, stop the spread of tuberculosis and prevent the disease from becoming drug-resistant,” said Ihor Kuzin, Deputy Minister of Health and Chief State Sanitary doctor.

The updated version of the standards of medical care “Tuberculosis” includes the following areas: 

• Public health protection and tuberculosis prevention. 
• Systematic screening for tuberculosis among high-risk groups.
• Diagnosis and treatment of tuberculosis, including those with drug resistance. 
• Management of HIV infection and other concomitant diseases in people with tuberculosis.
• Management of tuberculosis in children and adolescents. 

What is new in the standards of medical care “Tuberculosis”:

• Updated standards for the management of tuberculosis in children and adolescents, including BCG vaccination among HIV-infected children, modern approaches to the diagnosis of TB in children and adolescents, and integrated algorithm for making decisions on the treatment of children under 10 years of age with probable pulmonary tuberculosis, modern approaches to the formation of pediatric TB treatment regimens are described.
• The standards for the treatment of sensitive TB by age and severity of the disease are updated. Reduced 4-month treatment regimens for sensitive tuberculosis were introduced instead of the traditional 6-month regimens.
• Standards for the treatment of drug-resistant tuberculosis are updated - the standard provides for regulating the choice of modern treatment regimens with the priority of fully oral treatment regimens. Ukraine is the first country in the European region to introduce innovative BPaLM/BPaL treatment regimens as part of routine use. 

Due to the BPaL regimen, the total duration of treatment for patients with drug-resistant tuberculosis is reduced by almost three times: 6-9 months versus 18-24 months, and patients no longer need to receive painful injections for many months. According to the results of clinical studies, this regimen increases the chances of recovery by up to 90 %.

The full text of the order and standards can be read at link.

The overall goal of the new standards in the treatment of tuberculosis is not only to recover without relapse for all patients but also to stop transmission and prevent the acquisition or expansion of additional drug resistance.