Heartland National TB Center, TDSHS recognized for successful efforts to treat patients with TB in Nuevo Laredo, Mexico

Tuesday, June 22, 2010

SAN ANTONIO – An ongoing binational project of the Heartland National TB Center in San Antonio and the Texas Department of State Health Services (TDSHS) has been recognized as the 2010 Border Model of Excellence on Tuberculosis.

The project, “Successful Ambulatory Care of Multi-drug Resistant TB in Nuevo Laredo, Mexico: Results of Los Dos Laredos Binational Project” – which is “Excelentes Resultados en el Tratamiento Ambulatorio de Tuberculosis Multi Fármaco Resistente en Nuevo Laredo, Mexico, Resultados de un Proyecto Binacional” in Spanish – was started in 1991.

The award was presented by the U.S.-Mexico Border Health Commission (BHC) Outreach Office at the New Mexico Office of Border Health, in collaboration with the BHC’s Mexico Section’s Tamaulipas Outreach Office.

“Globally, nearly 500,000 people have multidrug resistant tuberculosis. The World Health Organization estimates that less than 2 percent receive adequate care. Most patients with MDR tuberculosis are treated in hospitals, which limits the number who can be treated and leads to long wait times,” said Barbara Seaworth, MD, medical director of the Heartland Center.

“The Los Dos Laredos Program showed that people with multidrug resistant tuberculosis could be successfully treated in an outpatient setting – even in a country with few medical resources – when expert medical consultation was combined with supervised treatment and good case management by nurses,” added Dr. Seaworth, who has been part of the effort since 1996.

The Heartland Center is a joint project between The University of Texas Health Science Center at Tyler and the TDSHS. It provides training, technical assistance, and medical consultation for TB in a 13-state region from its headquarters in San Antonio.

The TDSHS started the Los Dos Laredos Binational Project to help medical professionals in the greater Nuevo Laredo area provide better care for people with tuberculosis.

The project set out to increase awareness of TB in the community, as well as to improve access to medical care, second-line TB drugs, laboratory and radiology services, and expert medical consultation.

In 2000, medical personnel from Heartland begin making monthly trips to Nuevo Laredo to consult with physicians there on multidrug resistant TB cases.

In addition, Heartland staff has trained nurses in Mexico in areas such as case management, laboratory support, and the use of second-line TB drugs provided by TDSHS.

Catalina Navarro, the Heartland nurse consultant who helped the Mexican nurses implement a system of case management said, “Good nurse case management is essential in Texas, and we felt that this would ensure patient safety, improve patients’ compliance with their therapy, and result in treatment success for difficult to treat patients in Mexico.”

Of the 80 patients enrolled in the project in Mexico, 62.5 percent successfully completed treatment, Dr. Seaworth said.

The treatment success rates of this project are similar or better than those reported globally, though lower than those in the United States, where about 90 percent are successfully treated, she said.

Unlike the United States, Mexico does not require people with tuberculosis to accept treatment.

Applicants for the award had to:
  • show that their program improves TB surveillance, control, prevention, and/or treatment;
  • explain how the technical approach used in the program is both innovative and clinically sound;
  • illustrate that their project targets populations along the U.S.-Mexico border with limited access to medical resources and that it meets the needs of those populations;
  • demonstrate that the results of their program can be measured; and
  • show that their program can be duplicated in other parts of the border region.
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