TB Control in Urban Settings: Authors: Said Mirza Sayedi fileUSAID-funded TB CARE I project is the...
Transcript of TB Control in Urban Settings: Authors: Said Mirza Sayedi fileUSAID-funded TB CARE I project is the...
TB Control in Urban Settings:���Urban DOTS contribution to treatment outcome of new sputum smear positive ���TB cases in Kabul city, 2008 – 2011
Authors: Said Mirza Sayedi1, Azizullah Hamim1, M. K. Rashidi2, G. Qader3, L. Manzoor4, ���F. Habibuddin5, P. G. Suarez6, D. Safi1 Affiliations: 1Technical Advisor, TB CARE I, Afghanistan; 2Country Project Director, TB CARE I, Afghanistan; 3Senior Technical Advisor TB CARE I, Afghanistan; 4Urban DOTS Team Leader, National Tuberculosis Program (NTP) of the Ministry of Public Health, Afghanistan; 5Urban DOTS Coordinator, National TB Program; 6Global TB Technical Lead, Management Sciences for Health, Arlington, USA
Kabul’s Poor Health Conditions § Health infrastructure insufficient to reach 5 million residents
§ Poor tuberculosis (TB) service delivery
§ Low TB treatment success rate = 46%
§ High TB treatment transfer out rate = 46%
TB CAP Responds § USAID-funded Tuberculosis Control Assistance Program (TB
CAP) introduced the urban directly observed treatment, short course (DOTS) program.
§ The program engaged both the public and private sectors in ���DOTS implementation in Kabul.
§ TB CAP conducted the following interventions:
v Trained health facility staffs on DOTS
v Conducted regular monitoring/supervision visits
v Improved coordination and collaboration between the public and private sectors
v Renovated facilities to provide a safer working environment for staff
For more information, please contact: S. Mirza MD, Technical Advisor, TB CARE I, Afghanistan; Tel: +93 700 481 618; Email: [email protected]
Acknowledgement The Government of the United States of America through the US Agency for International Development (USAID) for funding the TB CARE I project.
TB CARE I Measures TB CAP’s Impact § USAID-funded TB CARE I project is the follow-on to TB CAP.
§ TB CARE I worked with National TB Program to measure the success of TB CAP’s urban DOTS intervention.
§ Collected TB data from 56 health facilities
§ Compared treatment outcomes from:
v 2008: pre-intervention
v 2009: intervention (began in July)
v 2010/2011: post-intervention
Conclusion § Urban DOTS helped to
significantly improve TB treatment outcomes in Kabul city (see table and graphs).
Recommendations § Urban DOTS should be
expanded in similar settings to improve TB case detection and treatment outcomes by engaging both the private and public sectors in DOTS implementation.
A health worker consulting a TB patient while providing DOTS in an urban facility
Urban DOTS Improves TB Treatment Outcomes in Kabul
Treatment Outcomes in New TB Sputum Smear Positive Cases
2008 N=875
2009 N=871
2010 N=1022
2011 (1stQ) N=240
Percentage Improvement
TB Treatment Success Rate 410 (47%) 383 (44%) 642 (62%) 170 (70%) 33%
Transfer Out of TB Treatment Rate 397 (46%) 387 (46%) 270 (26%) 55 (23%) 23%
Death Rate 17 (2%) 18 (2%) 22 (3%) 2 (1%) 1%
Treatment Failure Rate 23 (3%) 41 (4%) 31 (5%) 3 (2%) 1%
Source: National TB Program, Afghanistan, surveillance data, 2008–2011
Trend of Transferred Out of TB Treatment Rate for New Sputum Smear Positive TB Cases in Kabul 2007 – 2011
— Transferred Out Rate
2008 2009 2010 2011 (1st Q)
0% 20% 40% 60% 80%
100%
2008 2009 2010 2011
Perc
enta
ge
Success rate National Target
0% 20% 40% 60% 80%
100%
2008 2009 2010 2011
Perc
enta
ge
Success rate National Target
0% 20% 40% 60% 80%
100%
2008 2009 2010 2011
Perc
enta
ge
Success rate National Target
0% 20% 40% 60% 80%
100%
2008 2009 2010 2011
Perc
enta
ge
Trend of Treatment Success Rate of New Sputum Smear Positive TB Cases in Kabul 2007 – 2011
— Treatment Success Rate���— National Target