Poster - Effectiveness of Monthly Interim Cohort Analysis (MICA) to Improve Enrollment and Treatment Adherence Among Drug-Resistant TB Patients in Indonesia
Indonesia is managing a rapid expansion and decentralization of MDR treatment, with increasing numbers of MDR patients accessing MDR treatment. However, Indonesia is struggling with a 30% diagnostic treatment gap: patients diagnosed but not accessing MDR-TB treatment. In the 2014 MDR cohort, an additional 25% was lost to followup
during MDR treatment, much of which occurred during the first three months of treatment. Monthly Interim Cohort Analysis (MICA) is a monthly activity led by the district TB Supervisor, together with patients’ organizations and CSOs, to increase treatment enrollment and adherence of all DR-TB patients residing in the district. While patient supporters and care givers routinely provide same-day follow-up for patients who miss appointments, the monthly MICA period means that a patient can be missing appointments for not more than one month before additional effort is taken to enable and ensure continued adherence. This paper shows the effectiveness of MICA implementation in several USAIDfunded, KNCV led Challenge TB project (CTB) districts in Indonesia.