The Kyrgyz Republic has one of the highest rates of drug resistant tuberculosis in the world. Nevertheless, like their colleagues in other countries of the former Soviet Union, the Kyrgyz TB specialists are skeptical of the safety and effectiveness of outpatient care. For decades their TB programs mandated lengthy inpatient treatment under the assumption that hospitalization reduces the potential of TB transmission in the general public and guarantees treatment during the most critical phase of therapy.

To provide an evidence base for policy reform and national scale-up of ambulatory treatment in April 2012, the USAID Quality Health Care Project (QHCP) initiated a pilot project introducing outpatient treatment for TB patients in the Issyk-Ata district of Chui Oblast. The project trained local health personnel on modern standards of detection, diagnosis, treatment, patient education and counseling. The project also introduced the latest molecular diagnostics technology (GeneXpertTM) for rapid detection of TB and drug resistance among TB patients.