Afghanistan TB CARE I Presentation-Urban DOTS · • Implement standard operating procedures (SOP)...
Transcript of Afghanistan TB CARE I Presentation-Urban DOTS · • Implement standard operating procedures (SOP)...
Improving TB Case Detection and Quality of Care through and Quality of Care through Implementation of Urban DOTS in Kabul, Afghanistan
Azizullah, Hamim, MD, MPHTechnical Advisor, TB CARE I - AfghanistanTechnical Advisor, TB CARE I Afghanistan
Background• Population: 5 million
• Overcrowding
• Irregular NTP monitoring and supervision visits to health facilities
• Overcrowding
• Unsanitary facilities• Poor TB indicators:
Case notification rate: 26%Conversion rate: 43%
• Inadequately trained health facility staff
Success rate: 46%
• Only 22 of106 health facilities provide • Insufficient communication and
coordination between the private/public sector and the
TB control services
• Poor health infrastructureNational TB Program (NTP)
Methodologygy• Create a partnership
between NTP and • Conduct DOTS awareness
raising events at health facilities between NTP and public/private sector
E d DOTS bli d
raising events at health facilities, schools and in communities
I l d d i • Expand DOTS to public and private health facilities in Kabul city
• Implement standard operating procedures (SOP) for TB case detection, treatment and
• Standardized DOTS recording and reporting
infection control
• Recruit more public and private recording and reporting tools
Recruit more public and private health facilities for DOTS implementation
Methodology (Cont.)
• Enrolled 56 public and 8 private
gy ( )
health facilities as TB diagnostic and treatment centers
• The 64 facilities:Provided free TB services to 75% of Kabul’s populationIdentified11,900 TB suspects
Parliament member speaking during the launch of Urban DOTS at Nomad Hospital in Kabul city suspects
Registered 3,282 TB casesUrban DOTS at Nomad Hospital in Kabul city
Urban DOTS Public-Private Mix Performance in TB Control 2009 2011TB Control, 2009-2011
P t Indicators 2009 2010 2011
Percentage Improved
Total health facilities in Kabul 106 111 111 NAH lth f iliti idi DOTS (TB Health facilities providing DOTS (TB diagnosis & treatment) 22 48 56 50%
TB suspects identified/examined 2,856 10,150 11,900 317%
All TB cases notified 1,934 2,738 2,728 41%New TB sputum smear positive ( SS+) cases notified 814 1,022 1,083 33%cases notified 814 1,022 1,083 33%
TB sputum smear conversion rate 43% 62% 70% 27%
New TB SS+ treatment success rate 46% 62% 70% 24%
Urban DOTS Public-Private Mix Performance in Identifying TB Suspects, TB Cases, and New SS+
14000
Cases in Kabul, 2009 – 2011
10000
12000
8000
10000
mbe
r
TB suspects
4000
6000Num
TB suspects
TB Cases
New SS+ cases
0
2000
Urban DOTS02009 2010 2011
year
Urban DOTS Implemented
Urban DOTS Public-Private Mix Performance in TB Sputum Conversion Rate in Kabul 2007-2011
100%
Sputum Conversion Rate in Kabul, 2007-2011
70%70%
80%
90%
62%
70%
50%
60%
70%
Performance
43%
30%
40%
50% Performance
National Target
Project Target
10%
20%
30%
Urban DOTS
0%2009 2010 2011
Implemented
RecommendationRecommendation• The urban DOTS public-private mix contributed
significantly to TB services and improved:Case notification S t i Sputum conversion Treatment success rate
• This strategy should be scaled up in other urban settings. g
Thank You
Azizullah, Hamim, MD, MPHTechnical Advisor TB CARE I-Afghanistan
E-mail: [email protected]: +93 797 109 109