Almost 19,000 people die every year from TB in Vietnam. Vietnam, with an estimated 198 new TB cases/ 100,000, ranks 12th among the 22 countries bearing 80% of the global TB burden. Vietnam also ranks 12th among the 27 countries bearing the highest MDR TB burden. The case detection rate for all forms of TB was only 77%. MDR TB rate is 4% among new TB patients and 23% among the re-treatment patients. The National TB Program (NTP) enrolled 713 patients in MDR-TB treatment in 2012, accounting for 19% of the estimated number of MDR-TB cases. The main reasons were the limitation of detection, diagnosis and treatment capacity of MDR-TB patients. In 2012, the HIV testing rate for TB patients was 59% and the percentage of HIV(+) among TB patients was 8%. Improvement efforts have proven effective and in 2014 TB patients who knew their HIV status was at 73% and the percentage of TB patients who also had HIV was down to 5%. It is important to continue to strengthen TB case detection methods, particularly among people living with HIV/AIDS (PLWHA), patients at non-TB public and private healthcare facilities, and other at-risk populations.
With the notable achievements, URC and PHI were granted to carry out a FAST project to improve TB infection control at Nam Dinh and Quang Nam Provincial Hospital of TB and Lung Disease (PHTB&LD) from 2013 to 2015. Quang Nam province has two cities – Tam Ky and Hoi An and 16 districts, housing 1.4 million populations, including 7% minorities. Quang Nam PHTB&LD is responsible for the provincial TB program in collaboration with district TB control teams belonging to district health centers (DHC). Each year, the provincial TB program enrolled nearly 1,700 patients in TB treatment.
The project strategies are:
- Promoting the adoption of safe work practices, such that TB transmission among both healthcare workers and patients within these facilities is reduced.
- Strengthening the leadership, ownership, and institutional capacities of institutions in charge of TB in the province.
- Sharing experiences, lessons learned and effective monitoring tools for expanding successful practices to other provinces in Vietnam.
University Research Co., LLC (URC) has been a pioneer in implementing public-private mix (PPM) in TB control and integrating TB and HIV services in Vietnam. With funding from the U.S. Agency for International Development (USAID), URC began working with the National TB Program (NTP) to strengthen TB services in Thai Binh Province through the Quality Assurance Project in 2007. That work continued through the USAID Health Care Improvement Project (HCI) to 2009. URC’s successful model for PPM and TB-HIV services collaboration, developed in Thai Binh, was introduced in Hai Duong and Nam Dinh provinces through HCI in 2010.
Since April 2011, URC has focused its efforts exclusively in Nam Dinh. URC supported interventions, which improved TB-HIV coordination and collaboration, service linkage and information exchange between TB and HIV facilities, quality of TB diagnosis and HIV counseling and testing service at five District General Hospitals (DGHs), which were not supported by other projects.