Dear Gyanshankar,

I think there is a place for the conversion of some sanatorium in very specialized units in the treatment of complicated or severe tuberculosis:

- Disseminated TB or TB with XDR MBT

- Patients with comorbidities: mental illness, transplant, HIV, COPD, diabet mellitus, some cancers during treatment or follow up, drug user, etc.

- Patients (adults or chidren) in a situation of social vulnerability, exclusion and physical or psychological dangers

These units can perform better than other information about the disease and treatment, patient education and prepare them to go out when the time will come. They include multicomponent specialized actors in their teams.

In France there is one unit of this type: " Le Sanatorium de Bligny "

www.chbligny.fr/services-specialites/sanatorium.html

Best Regards

Jean

Yes, Drug resistance, comorbidities and social isolation are definitely some of the cases that will benefit from such services. The example sanitoria does seem to be a specialised center. Also many chronic Pulmonary TB patients who will be increasing the infectious disease pool in the community need to be isolated till sputum conversion atleast.

Dear Gyanshankar,

The question and answer are probably different in countries with high or low prevalence and incidence of TB. There is no doubt that the rehabilitated structures could host, isolate, eat, cure and care many patients and together form health actors.

I remember, I was a young pulmonologist thirty years ago in a Sanatorium.

Best Regards.

Jean.