DR-TB for experts

J&J DR-TB Academy

Week 0
LAUNCH SESSION LIVE (Kamis, 03 Juni 2021. 16:00-17:00 WIB)
• Introductions
• Review course content and platform
• Pre-test

Week 1 Epidemiology and clinical characteristics

EU1 (30 mins)
GLOBAL TB & DR-TB EPIDEMIOLOGY & POLICY
• Global burden of disease
• Interaction with other diseases and social determinants
• Current state of response
• Gaps in knowledge & response
• Monitoring and evaluation framework
EU2 (30 mins)
TB & DR-TB BURDEN IN HOST COUNTRY (PRE-RECORDED INDONESIAN EXPERT)
• Epidemiological situation
• Country response
• Impact of other disease and social determinants
• Successes and challenges
EU3 (30 mins)
OVERVIEW OF THE CLINICAL MANIFESTATIONS OF DR-TB
• Risk factors for DR-TB
• Combining clinical and laboratory findings
• Updates on the role of radiology
EU4 (20 mins)
CLINICAL DECISION-MAKING IN SPECIAL GROUPS
• Diagnostic challenges with special groups
• Clinical characteristics in children, PLHIV and others with immunosuppression.

EU5 (60 mins)

LIVE SESSION (Kamis, 10 Juni 2021. 16:00-17:00 WIB.
• Zoom link Fasilitator: Dr. Prayudi Santoso, Sp. PD-KP, Mkes
Topik Diskusi Kasus: Epidemiology and clinical characteristics
DR-TB for experts
J&J DR-TB Academy

Week 2: Diagnostics & Treatment principles

EU1 (40 mins)
LABORATORY DETECTION OF DRUG-RESISTANCE
• Overview of molecular methods of drug-resistance
• Diagnostic performance of available tests including Xpert Ultra & Hain LPA
• Validity of phenotypic DST – gaps in performance of pDST
• DST for newer drugs
EU2 (20 mins)
LABORATORY DETECTION OF DRUG-RESISTANCE: NEWER METHODS
• Sequencing:
o WGS vs targeted NGS
o Role in clinical practice
o Strengths & weaknesses
EU3 (30 mins)
LABORATORY TO BEDSIDE – TRANSLATING RESULTS INTO TREATMENT CHOICES
• Key clinical information
• Validity of laboratory results
• Importance of specimen collection techniques
• Diagnostic algorithms
• Individualised treatment approaches – a review of the evidence
EU4 (20 mins)
TREATMENT PRINCIPLES FOR DR-TB
• Evolution and evidence supporting WHO recommendations
• Overview of the mechanism of action and classification of drugs
• Target regimen profiles and ongoing clinical trials
• Treatment delivery models

EU5 (60 mins)

LIVE SESSION Kamis, 17 Juni 2021. 16:00-17:00 WIB.
• Zoom link Fasilitator: DR. Dr. Soedarsono, SpP(K), FISR
Topik Diskusi Kasus: Diagnostics & Treatment principles
DR-TB for experts
J&J DR-TB Academy

Week 3: Treatment of DR-TB

EU1 (40 mins)
TREATMENT OF RR/MDR-TB
• Recommended regimen composition and durations
• Shorter regimens for RR/MDR-TB
• Extra-pulmonary RR/MDR-TB
• Managing advanced drug resistance

EU2 (40 mins)

COMPLEX RR/MDR-TB TREATMENT
• Managing cases with advanced resistance
• End organ failure
• Chronic hepatitis C virus
• Drug-drug interactions and therapeutic drug monitoring
EU3 (30 mins)
TREATMENT OF ISONIAZID MONO-RESISTANT TB
• Impact of isoniazid resistance
• Updated global recommendations
EU4 (30 mins)
TREATMENT OF MOTHERS AND CHILDREN
• Children
• Pregnant and breast-feeding women
EU5 (40 mins)
TREATMENT OF PLHIV AND CONTACTS OF DR-TB
• PLHIV
• Contacts
EU6 (30 mins)
MANAGING TREATMENT INTERRUPTIONS
• When to interrupt treatment
• How to restart treatment
• When and how to construct a new regimen

EU7 (60 mins)

LIVE SESSION Kamis, 24 Juni 2021. 16:00-17:00 WIB.
• Zoom link Fasilitator: Dr Pompini Agustina, SpP(K)
Topik Diskusi Kasus: Treatment of DR-TB
DR-TB for experts
J&J DR-TB Academy

Week 4: Managing side-effects

EU1 (30 mins)
OPTIMISING TREATMENT THROUGH MONITORING AND ADHERENCE SUPPORT
• Recognising inadequate treatment response
• Early detection of side-effects
• Options for adherence support and patient education
EU2 (25 mins)
CARDIAC SAFETY OF DR-TB TREATMENT
• Drug-induced prolonged QT
• Risk factors for arrhythmias
• Monitoring for QT-prolongation
• Management of cardiac toxicity

EU3 (30 mins)

NEUROPATHY ASSOCIATED WITH DR-TB TREATMENT
• Drugs associated with neuropathy
• Risk factors for neuropathy
• Monitoring for neuropathy
• Management of drug-induced neuropathy

EU4 (20 mins)

OTOTOXICITY AND OTHER IMPORTANT SIDE-EFFECTS
• Detecting ototoxicity
• How to manage a person with signs of ototoxicity
• Children
EU5 (60 mins)
LIVE SESSION Kamis, 01 Juli 2021. 16:00-17:00 WIB.
• Zoom link Fasilitator: Dr. Thomas Handoyo, SpPD-KP
Topik Diskusi Kasus: Managing side-effects
POST-TEST AND COURSE EVALUATION