Video-Controlled Treatment of Tuberculosis Patients in the Kyrgyz Republic

The objective: to evaluate treatment outcomes in tuberculosis patients when using video-controlled treatment.

Subjects and Methods. The study was designed as a retrospective one. Subjects were the following: 854 tuberculosis patients, who received anti-tuberculosis treatment in medical units of Bishkek and Chui Region in the out-patient settings using different treatment observation models, in 2020-2022. Patients were divided in 2 groups: Main Group and Control Group. Main Group (MG) included 422 patients who were on video-controlled treatment (VCT) of tuberculosis drugs, and Control Group (CG) – 432 patients who were on directly observed treatment (DOT).

Results. The majority of included patients (85.3%) lived within 3 kilometers from the healthcare organization, therefore, the use of video-controlled therapy is convenient for daily intake of TB drugs for both patients and healthcare workers. It has been found that VCT is not inferior to traditional DOT in terms of treatment outcomes: treatment success made 98.1% versus 79.6%, %, while lost to follow-up made 1.2% versus 9.9%, p> 0.05.  It has been revealed that the proportion of missed doses of TB drugs in VCT Group is higher for DS-TB and DR-TB than in DOT Group (3.3% versus 2.5%, 10% versus 4.4%, respectively).  While in VCT, the facts of absent on treatment were better documented, and the reasons for missed doses were identified and eliminated in a timely manner.

Conclusion. The success of TB treatment using video-controlled intake of TB drugs is not inferior to traditional directly observed TB treatment and can be recommended for further use. The higher treatment effectiveness when using VCT is due to the fact that the study group included patients with good adherence, organizational problems were solved during the treatment: donors paid the Internet costs, TB drugs were delivered to the patient, and patients received some incentives. An important aspect of VCT is the reduction of risk of infecting others while traveling, i.e. prevention of tuberculosis spread. 

1. Vnutrennyaya migratsiya v Kyrgyzstane: baryery i puti sotsialnoy mobilnosti. Sbornik statey mezhdunarodnoy organizatsii po migratsii. [Internal migration in Kyrgyzstan: barriers and pathways to social mobility. A collection of articles from the International Organization for Migration]. Bishkek, 2018. Available: https://kyrgyzstan.iom.int/sites/g/files/tmzbdl1321/files/documents Accessed October 11, 2025

2. Instructions on Video-Guided Treatment (VCT) of Tuberculosis in Healthcare Units of the Kyrgyz Republic. Edict No. 202 On Expanding the Tuberculosis Case Management Approach as of February 17, 2021. (In Russ.) Available: http://tbcenter.kg/media/book/2022/07/26/prikaz-mz-kr-202-ot-17-02-2021g-o-rasshirenii-podkhoda-upravleniia-sluchaem-tb.pdf Accessed October 11, 2025

3. Kadyrov A.S., Myrzaliev B.B., Ahmatov M.B., Sulaymanova M.I. Preliminary results of pilot video observed treatment for patients with tuberculosis in the Kyrgyz Republic. Nauchno-Prakticheskiy Journal Zdravookhraneniye Kyrgyzstana, 2019, no. 1, pp. 68-72. (In Russ.)

4. Kyrgyzstan na vtorom meste reytinga samogo deshevogo mobilnogo interneta v mire. [Kyrgyzstan ranks second in the world for the cheapest mobile internet]. Informatsionnoye Agentstvo 24kg Publ., Bishkek. Available: https://24.kg/tehnoblog/216435_kyirgyizstan_navtorom_meste_reytinga_samogo_deshevogo_mobilnogo_interneta_vmire/ Accessed September 10, 2025

5. WHO consolidated guidelines on drug-resistant tuberculosis treatment. National Phthisiology Center, Bishkek, Kyrgyzstan. Available: http://tbcenter.kg/media/book/2023/12/04/kr-po-lu-tb-19-09-23.pdf Accessed November 11, 2025

6. Mobidnaya svyaz v Kyrgyzstane. Infografika Natsionalnogo statisticheskogo komiteta Kyrgyzskoy Respubliki. [Mobile communications in Kyrgyzstan. Infographics from the National Statistical Committee of the Kyrgyz Republic]. Bishkek. Available: http://www.stat.kg/ru/news/den-interneta-99-kyrgyzstancev-ohvacheny-mobilnymi-setyami/ Accessed October 11, 2025

7. Pavlyuchenkova N.A., Vasilyeva I.A., Samoylova A.G., Tyulkova T.E. Video observed treatment is an innovative method of tuberculosis treatment observation in resource-limited health care settings. Tuberculosis and Lung Diseases, 2022, vol. 100, no. 2, pp. 53-60. (In Russ.) https://doi.org/10.21292/2075-1230-2022-100-2-53-60

8. Provision on the Public (Voluntary) Assistant for Controlled Treatment of Tuberculosis Patients in Outpatient Settings. Order No. 542 by the Ministry of Health of the Kyrgyz Republic as of June 19, 2017. (In Russ.) Available: http://tbcenter.kg/media/book/2022/07/20/3-prikaz-542-ot-19-06-2017g-ob-obshchestvennom-pomoshchnike.pdf Accessed October 22, 2025

9. WHO consolidated guidelines on tuberculosis: module 4: treatment: drug-susceptible tuberculosis treatment. (In Russ.) Available: https://iris.who.int/bitstream/handle/10665/374004/9789289058964-rus.pdf Accessed October 23, 2025

10. End TB Strategy Progress in implementing the global strategy and targets for tuberculosis prevention, care and control after 2015 (the End TB Strategy). (In Russ.) Available: https://apps.who.int/gb/ebwha/pdf_files/EB154/B154_10-ru.pdf Accessed November 15, 2025

11. Toktogonova A.A., Kulzhabaeva A.A., Myrzaliev B.B. Prevalence of various strains of the causative agent of tuberculosis in tuberculosis patients in the Kyrgyz Republic. Health Care of Kyrgyzstan, 2022, no. 2, pp. 20-28. (In Russ.)

12. Aldridge R.W., Story A., Catherine M.S. et al. Smartphone-enabled video-observed versus directly observed treatment for tuberculosis: a multicentre, analyst-blinded, randomised, controlled superiority trial. Lancet, 2019, vol. 393, no. 10177, pp. 1216-1224. https://doi.org/10.1016/S0140-6736(18)32993-3

13. Chuck C. Enhancing management of tuberculosis treatment with video directly observed therapy in New York City. Int. J. Tuberc. Lung Dis., 2016, vol. 20, no. 5, pp. 588-593. https://doi.org/10.5588/ijtld.15.0738

14. How we change our approach to TB treatment under Covid-19. UNDP. Global Fund TB project report. https://www.kg.undp.org/content/kyrgyzstan/en/home/blog/2020/tb-and-covid-.html

15. Karumbi J., Garner P. Directly observed therapy for treating tuberculosis. Cochrane Database of Systematic Reviews, 2015, no. 5, pp. CD003343. https://doi.org/10.1002/14651858.CD003343.pub4

16. Munro S.A., Lewin H.J., Smith H.E. et. al. Patient adherence to tuberculosis treatment: a systematic review of qualitative research. PLos Med., 2007, vol. 4, no. 7, pp. 238. https://doi.org/10.1371/journal.pmed.0040238

17. Rabinovich L., Molton J.S., Ooi W.T., Paton N.I., Batra S., Yoong J. Perceptions and acceptability of digital interventions among tuberculosis patients in Cambodia: qualitative study of video-based directly observed therapy. J. Med. Internet Res., 2020, vol. 22, no. 7, pp. e16856. https://doi.org/10.2196/16856

18. Spruijt I., Alam Y., Nguyen H.net al. Digital health solutions and integrated COVID-19 and TB services to help recover TB care and prevention services in the COVID-19 pandemic: a descriptive study in four high TB burden countries. PLOS ONE, 2023, vol. 18, no. 11, pp. e0293964. https://doi.org/10.1371/journal.pone.0293964

19. WHO. A brief guide to video-assisted treatment of TB-WHO-2020. Available: https://apps.who.int/iris/bitstream/handle/10665/335901/9789289055260-rus.pdf Accessed September 27, 2025

20. WHO. Digital health for the End TB strategy, 2017. Available: https://apps.who.int/iris/bitstream/handle/10665/259832/9789241513456-eng.pdf Accessed September 27, 2025

21. WHO. Global Tuberculosis Report 2022. Available: https://www.who.int/teams/global-tuberculosis-programme/tb-reportsAccessed September 27, 2025

22. WHO. Guidelines for treatment of drug-susceptible tuberculosis and patient care 2017. Available: http://www.who.int/tb/publications/2017/dstb_guidance_2017/en/.Accessed September 27, 2025

23. WHO, Tuberculosis, Key Facts. October 14, 2021. Available: www.who. int/ru/news-room/fact-sheets/detail/tuberculosis Accessed September 27, 2025