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The FAST strategy is mainly implemented at specialized and general hospitals with TB units. With support from the USAID TB CARE II Project, the Vietnam NTP developed the “Guideline for FAST strategy implementation”. According to the Guideline, implementing facilities should immediately order GeneXpert MTB/RIF tests for eligible patients including: Pulmonary TB patients AFB(+), presumptive drug-resistant TB patients, presumptive TB among HIV positive people, children with presumptive TB or TB meningitis.
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.
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.
The community MDR TB planning tool focuses on operationalizing implementation of MDR TB community level interventions, drawing on information gained from the experience of several countries implementing a community model to deliver MDR TB services to patients.
The tool provides a situation analysis table to facilitate understanding of the health system context and model to provide MDR TB services in country, and considers TB and MDR TB country/district burden and the resources available in order to identify gaps in provision of MDR TB services.
international and national evidence-based standards and guidelines have been developed. Having explicit standards and guidelines helps ensure high-quality care, better health outcomes, and cost effective treatments. In addition, they provide a reference point for assessing provider or system performance and quality of care. It is important to note, however, that adherence to these guidelines is not just a result of the development and dissemination of them, but of integrating the guidelines as part of a quality management program.