.

TB CARE II recently hosted two technical meetings on TB infection control in Bethesda, MD.  The first, which was held May 5-6 and hosted in partnership with Partners in Health, focused on the development of standards for use of ultraviolet germicidal irradiation (UVGI) in TB settings. 

The second, held May 7-8, reviewed lessons learned from implementation of the FAST strategy, an innovative method of TB and MDR TB case finding in hospital and clinic settings, to reduce nosocomial TB and MDR TB transmission.  TB CARE II has been piloting the FAST strategy in a variety of country settings, including Bangladesh, Malawi, and Vietnam.  Around 50 participants from 14 countries attended the meetings, including representatives from USAID, MOHs, NTPs, and TB CARE II and URC staff from around the world.

A new technology entitled GeneXpert was deemed a ‘game-changer’ in the world of TB diagnostics.  To reduce the burden and mortality of TB, it is imperative to not only have advanced technologies to detect TB bacteria, but to also have experts that know how to use the new technology.  In 2016, USAID TB CARE II funded the attendance of 11 people from select low or middle‐income countries to attend the McGill Summer Institute in Infectious Diseases and Global Health to take courses on Advanced TB Diagnostic Research. The objectives of the courses were for participants to advance their learning on TB diagnostics, and be inspired to adopt and implement innovative tools and approaches and become champions for TB control.
 
 

Those with week immune systems are highly susceptible to developing TB if they come into contact with TB bateria.  Healthcare facilities are challenged with treating patients with TB, while simultaneously preventing other ill patients from contracting TB.    Technologies, such as UVGI, have been adapted to help healthcare systems in protecting their patients from TB.  However, technology introduction requires new guidelines, local manufactures, and experts to maintain it.   TB CARE II is working to implement UVGI technology in high TB burden areas around the world.  

In 2014, approximately 480,000 people developed MDR-TB.  3.3% of new cases and 20% of previously treated patients develop MDR-TB.  It was estimated that only 41% of cases were notified that they had MDR-TB in 2014.  In low and middle income countries, access to quality TB services is often limited.  Since the beginning of TB CARE II in 2010, TB CARE II has worked to decrease MDR-TB.  TB CARE II has: held over 6 trainings on MDR-TB, with more than 307 people attending the trainings, sponsored 7 fellows in PMDT Fellowship program, developed over 4 tools and 2 mHealth apps that brought over 396 downloads and were utilized by over 50 patients, and hosted 42 webinars with more than 1300 people participating in the webinars.
 
 

   In 2015, USAID TB CARE II project began an initiative to address TB in miners in the Southern African Region.  The overall objective is to improve detection and management of TB and other co-morbidities among the mine workers and their families.  This would also help to control the spread of TB and reduce new incidences of TB.  Mine workers are exposed to a multitude of factors that compound their risk of TB infection, including working conditions (prolonged exposure to silica dust, poor ventilation), exposure to occupational hazards, socio-economic factors (cramped and unsanitary living conditions, limited access to health services), and disease burden (co-exposure to HIV, silicosis, or both). TB and silicosis have long been recognized as occupational diseases.  The risk of a person with silicosis developing TB is 2.8 to 3.9 times higher than that in healthy controls.  

A training curriculum for an Ethics of Tuberculosis Prevention, Care and Control  training course has been developed. The training curriculum includes a facilitator-led training guide along with presentations and activities for the interactive 2-day course which is intended to introduce the concept of ethics in tuberculosis prevention, care and control and to sensitize and educate delegates on the application of ethical values in their work.  All materials necessary to plan and implement the course can be accessed at: http://globaltb.njms.rutgers.edu/educationalmaterials/productfolder/tbethicscurriculum.html

 

Click below to view the video:

Photo from TB in children video

 

Stories From The Field

Md. Anwar Hossain is a 38-year old father of two who hails from the district of Narayanganj. As an engineer at one of Bangladesh’s many textile factories, Anwar prides himself in supporting his family and helping his two sons gain a quality education. Naturally, then, he was dismayed when he learned that he may no longer have the ability to take care of them.

Seven years ago, Anwar was diagnosed with tuberculosis (TB). He underwent a treatment regimen and believed he had beaten the disease. Last year, however, he began to feel ill once again. After visiting a nearby clinic, doctors diagnosed him with multi-drug resistant TB (MDR TB), which can occur when there is an interruption in TB treatment. This form of TB takes longer to treat and requires specialized drugs, which are more expensive and can require the patient to remain hospitalized for an extended period of time. His job, his family, and his life were all in jeopardy as a result of this new diagnosis.

The Experience of Catherine Pelani

Access to health care services among rural, resource-poor people in low-income countries remains a major obstacle to TB control efforts. A critical factor is the need to improve access to diagnostic facilities, which in many rural areas double as TB treatment initiation and registration centres for TB patients. It is common for patients to travel over 50 kilometers to access TB treatment initiation services. Thanks to the USAID TB CARE II project, more than 31, 558 people living near the Chilipa Health Centre can now access TB diagnosis and treatment close to their communities.

Universal Access

DOTS represents the best strategy for coordinating TB services within the broader health system, mobilizing wide support at the operational level, reducing TB incidence, and preventing further drug resistance.

PMDT

Programmatic Management of Drug-resistant TB (PMDT): While the causes of multi-drug resistant TB are similar in all high burden countries (low adherence, weak DOTS, poor treatment compliance, inadequate drug supplies, direct transmission, etc.).

TB / HIV

TB CARE II works to link HIV and TB advocacy and to promote a unified response, and works with National TB and HIV/AIDS Programs to integrate planning and service delivery mechanisms to effectively tackle the dual epidemics.

Health Systems Strengthening

TB CARE II supports health systems improvement through our country programs, emphasizing management capacity building, integration, and results-oriented process improvement.

UVGI: Using Innovative Technology to Fight TB

Those with week immune systems are highly susceptible to developing TB if they come into contact with TB bateria.  Healthcare facilities are challenged with treating patients with TB, while simultaneously preventing other ill patients from contracting TB.    Technologies, such as UVGI, have been adapted to help healthcare systems in protecting their patients from TB.  However, technology introduction requires new guidelines, local manufactures, and experts to maintain it.   TB CARE II is working to implement UVGI technology in high TB burden areas around the world.   read more

TB in Mines

   In 2015, USAID TB CARE II project began an initiative to address TB in miners in the Southern African Region.  The overall objective is to improve detection and management of TB and other co-morbidities among the mine workers and their families.  This would also help to control the spread of TB and reduce new incidences of TB.  Mine workers are exposed to a multitude of factors that compound their risk of TB infection, including working conditions (prolonged exposure to silica dust, poor ventilation), exposure to occupational hazards, socio-economic factors (cramped and unsanitary living...read more