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The National Course on the Clinical Management of Drug-Resistant Tuberculosis for Myanmar is a four-week virtual training course, consisting of on-demand videos, interactive online sessions, quizzes, discussions and practical exercises, aiming to strengthen participants’ capacity in the clinical and programmatic management of drug-resistant tuberculosis.
Week 1
- Principles of TB care and prevention
- TB: The organism and the host
- Basic concepts of drug-resistance in TB
- Global and national epidemiology of drug-resistant TB and contributing factors
- Clinical and radiographic manifestations of TB and drug-resistant TB
- Conventional anti-TB drug susceptibility testing
- Rapid diagnosis of drug-resistant TB: Xpert
- Rapid diagnosis of drug-resistant TB: Line probe assay
Week 2
- Case finding of drug-resistant TB
- Treatment of new and previously treated TB, isoniazid-resistant TB
- Treatment of rifampicin-resistant TB: long regimen and fluoroquinolone
- Bedaquiline, linezolid, Clofazimine
- Delamanid, Pretomanid, Imipenem/Meropenem
- Short course chemotherapy for MDR-TB
- HIV and MDR-TB: clinical manifestations and diagnosis
- Management of DR-TB among people living with HIV
Week 3
- Active tuberculosis drug safety monitoring and management (aDSM)
- Management of adverse drug reactions
- Management of DR-TB in patients with liver disease, renal insufficiency and pregnancy
- MDR-TB in children and management of contact of DR-TB
- Surgical intervention in the management of MDR- and XDR-TB
- Care and support for patients with MDR/RR-TB
- Infection control - minimal requirements
- Management of drug-resistant TB in the era of COVID-19
At the end of this course, participants will be able to:
- Describe the current global and national epidemiological situation of drug-resistant tuberculosis
- Review the different approaches for the detection and diagnosis of drug-resistant tuberculosis in Myanmar
- Address the principles of anti-tuberculosis treatment, according to different patterns of drug-resistance in Myanmar
- Describe second line anti-tuberculosis medicines and new and repurposed drugs
- Discuss common problems and possible solutions for programmatic management of drug-resistant tuberculosis in Myanmar
This course is designed for clinicians, who are responsible for diagnosis and treatment of drug-resistant tuberculosis, staff of the National Tuberculosis Programme and technical partners, working in tuberculosis care and prevention in Myanmar.
Dr Chen-Yuan Chiang. Dr Chiang is a senior consultant of The Union and professor of medicine of Taipei Medical University. He was a member of the core group of Global drug-resistant tuberculosis initiative (GDI) and the Western Pacific Regional GLC. Currently, he serves on Technical Advisory Group on Tuberculosis in the Western Pacific Region of WHO. He has provided technical assistance to several national TB programmes in Asia and Africa. Dr. Chiang has previously coordinated and facilitated several international and national courses on clinical and programmatic management of drug-resistant TB.
Dr Mar Mar Htay. Dr. Mar Mar Htay started working in the public health filed soon after her graduation from the Medical University. She had dedicated her career life to TB control activities by working as a District TB team leader for 10 years in Magway Region. After getting the diploma for TB and Chest Disease, she worked as the State TB officer of Rakhine State for over three years and another three years as the Regional TB officer of Ayeyarwaddy Region. Then, she was assigned to be the Senior Consultant (TB) of Aung San TB Specialty hospital for two years during which she took care of many DR-TB patients including difficult clinical cases. After 20 years of service in TB control, she retired. But her enthusiasm for TB care and prevention made her to resume her career in a Local NGO called MHAA supporting the National TB Program. After a while, she joined WHO-TB team in Myanmar to be a National Technical Officer (MDR-TB). She has been providing clinical consultations in MDR-TB clinics of Yangon Region, giving advice to junior doctors of the Aung San TB specialty hospital, and taking part in many clinical meetings. She also gives trainings for basic health staff and for medical doctors specifically to roll out shorter regimens, and to monitor and manage adverse effects.
Dr Rebecca Lin. Taiwan-based Rebecca Chou-Jui Lin is a pulmonologist working in Taoyuan General Hospital, Ministry of Health and Welfare and one of the lead physicians of the five MDRTB teams in Taiwan. Rebecca has also participated in DRTB workshops and technical assistance in Vietnam and the Philippines. Over the years, her patients had taught her how to appreciate simple but important things in life: a genuine smile, a few kind words, and a cup of good coffee, from which we can all find courage to move on.
Dr Ignacio Monedero (Nacho) is a medical doctor with more than 20 years of clinical practice. For the past 16 years, he has worked in the programmatic and clinical management of TB working in more than 30 countries. After graduating from medical school, Nacho worked for two years in Sub-Saharan Africa in TB and HIV, and then did an MSc on Public Health. In 2008, Nacho joined the Union as a TB-HIV and DR-TB consultant, delivering since then more than 45 clinical trainings. He is the author of more than 30 peer reviewed publications and collaborator of Union and WHO guidelines. Nacho works internationally for the Union and WHO and holds several academic and clinical positions in Spain (including the management of Covid-19 outbreaks). Nacho is a core member of the GDI and a member or EMRO rGLC.
Dr Thein Myint is a National Technical Officer for the TB Unit of the World Health Organisation in Myanmar. After obtaining a degree in TB and Chest Disease (Dip.Med.Sc) in 2012, he worked on the programmatic and clinical management of DR-TB at the National Tuberculosis Programme (Myanmar). Dr. Myint is one of the lead TB specialists. He has participated in the implementation of injection-based shorter treatment regimen in Myanmar under the NTP leadership and with WHO support. Dr. Myint has facilitated many trainings on the clinical management of DR- TB for clinicians in Myanmar and the implementation of injection-based regimens and oral regimens. He joined WHO (TB-unit) Myanmar in 2020 providing technical inputs for the amendment of the National DR-TB guidelines and support to the National TB Programme.
Dr Aye Thida. Dr Aye Thida is a National Professional Officer (MDR-TB/ TB/HIV) of WHO country office-Myanmar. She was the medical coordinator of Medecins du Monde (MDM in Myanmar) and the deputy head of office of The Union (Myanmar). During her career life in INGOs, her passion for TB and HIV control activities grew. She studied Master of Clinical tropical medicine in Mahidol University and mater of public health (Disease Control) in ITM (Antwerp). Currently, she serves as the Technical Focal Point on Drug-resistant Tuberculosis in WHO-TB (Myanmar) and provides secretariat support to the National Expert DR-TB Committee. She has provided technical advice and assistance to NTP-Myanmar, coordinated, and provided technical assistance to update National DR-TB guidelines and given trainings on DR-TB at national level and sub-national levels.
The course will take place over four (4) weeks. Each week, you will have to follow and complete eight (8) pre-recorded presentations of about 30 minutes duration each, as well as participate in two live sessions of about 90min each.
The course starts with an introductory session and a pre-test, and it concludes with a post-test and course evaluation.
The live sessions will be accessible via a unique Zoom link:
https://us06web.zoom.us/j/88600253449
Meeting ID: 886 0025 3449
Intro session: Thursday 1st September, 1pm Barcelona / 5:30pm Naypyidaw / 7pm Taipei / 9pm Sydney
Live session 1: Monday 5th September, 1pm Barcelona / 5:30pm Naypyidaw / 7pm Taipei / 9pm Sydney
Live session 2: Thursday 8th September, 1pm Barcelona / 5:30pm Naypyidaw / 7pm Taipei / 9pm Sydney
Live session 3: Monday 12th September, 1pm Barcelona / 5:30pm Naypyidaw / 7pm Taipei / 9pm Sydney
Live session 4: Thursday 15th September, 1pm Barcelona / 5:30pm Naypyidaw / 7pm Taipei / 9pm Sydney
Live session 5: Monday 19th September, 1pm Barcelona / 5:30pm Naypyidaw / 7pm Taipei / 9pm Sydney
Live session 6 and closing session: Thursday 22nd September, 1pm Barcelona / 5:30pm Naypyidaw / 7pm Taipei / 9pm Sydney
The agenda of the live sessions will change slightly each time but these are the main elements:
1) Q&A with the faculty about the pre-recorded lectures, presentations of latest WHO recommendations and context in Myanmar
2) Presentation of clinical cases and discussion in plenary, feedback from faculty
3) Practical exercises and discussion in smaller groups
Participation in the live sessions is compulsory. We recommend participants to review the supporting documents for live sessions (in particular the clinical cases and the practical exercises) before attending the live sessions so they can prepare their contributions.
Pre-assessment
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Supporting documents for live sessions
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Week 1 | Part 1
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Week 1 | Part 2
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Week 2 | Part 1
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Week 2 | Part 2
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Week 3 | Part 1
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Week 3 | Part 2
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Assessment and Evaluation
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