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Lessons learned from the development of a generic aDSM guideline and its adaptation to Senegal

Published onJun 13, 2023
Lessons learned from the development of a generic aDSM guideline and its adaptation to Senegal

Background: Active tuberculosis (TB) drug safety monitoring and management (aDSM) is a key component for the use of new TB drugs for the treatment of drug-resistant TB (DR-TB). Despite widespread use of the new anti-TB drugs by National Tuberculosis Programmes (NTPs) in the West and Central Africa networks for TB control (WARN/CARN-TB) group, scaling up of aDSM remains weak. In 2021, an assessment conducted in the network showed that few NTPs had developed national guidelines for aDSM. We documented measures taken by the WARN/CARN-TB project and WHO-TDR to overcome this challenge. 

Intervention: From October to December 2021, a working group composed of representatives of NTPs and pharmacovigilance departments from WARN/CARN-TB countries was set up. Their task was to develop a generic aDSM country guideline. Virtual meetings were held along with WhatsApp group exchanges. To adapt the generic guideline to the national context, a field visit was carried out in Senegal with a team composed of members of the working group. 

Results: 21 countries from WARN/CARN-TB took part in the working group composed of a variety of profiles (pharmacists, clinicians). Four virtual meetings over a three-month period were necessary to develop the aDSM guide. A five-membered team from the working group field-tested the guide in Senegal. In-person meetings with the NTP and pharmacovigilance authorities of Senegal were held over a one-week period which resulted in the drafting of the national aDSM practical guide allowed to field-test. 

Conclusions: The development of a generic country guide for aDSM was made possible through South-South technical collaboration through the WARN/CARN-TB. The process of adapting the guideline to Senegal was an opportunity to further contribute to capacity building in the region. The generic guideline is now available for all countries (to facilitate the effective implementation of a comprehensive aDSM system).

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