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Early TB detection and treatment efficiency enhancement among the most at risk

populations in Ukraine

AIDS 2014, Melbourne22 July 201413:00-14:00

Zahedul IslamInternational HIV/AIDS Alliance in Ukraine

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Epidemiology

2005 2006 2007 2008 2009 2010 2011 2012 20130

10

20

30

40

50

60

70

80

90

84.1

83.279.8 77.8

72.7 68.4 67.2 68.1 67.9

29.234.4 38 40.9 43.2 44.7 46.2 45.5 47.6

4.3 5 6.3 7.4 8.7 9.1 10.4 10.5

Incidence HIVIncidence TB Incidence TB/HIV

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Background

Pilot started in April 2013, Alliance provided support to 39 NGOs in all regions of Ukraine.

Purpose: to decrease TB prevalence and mortality rate among MARPs through early detection and timely unhampered access to medical services.

 

The target groups of the project are FSWs, IDUs and IDU partners, MSM and most-at-risk adolescents.

 

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Project DescriptionStarting from April 2013, 39 partner NGOs which implement harm-reduction programs, included early TB detection in their scope of services.

Preparation:- Established partnership with healthcare institutions to create a mechanism of

services provision for most

vulnerable population (e.g., PWID, CSW, MARA). - Trainings for NGO’s social workers on

early TB detection and infection control measures

were conducted

Implementation:- Screening questionnaires for early

TB symptoms- Sputum collection on sites - Referral to healthcare institutions- Implementation of IC measures in NGO’s

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Early TB detection outcomes

10218TB screening

5707TB

diagnostics

659TB detection

(all forms)

542 TB detection

(newly diagnosed

and relapse)

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Challenges in TB diagnostics and treatment

• Vertical structure of healthcare system and low availability of the said services outside the TB service

• High level of stigmatization and discrimination of the most-at-risk populations, especially IDUs, in the healthcare system

• Low awareness on the importance of timely diagnostics and treatment of TB, on possible ways to obtain these services

• Chaotic lifestyle, low social and economic status and low motivation of the clients to preserve their own health

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Conclusions/Next steps

• Active TB case detection in NGOs working with MARP’s (HIV-infected, IDUs and others) has proven its effectiveness.

• Detection of TB in these groups exceeded the overall detection rate in primary health care.

• Collaboration between the clinics and NGOs allowed to improve access to TB care for most vulnerable populations.

• Starting from 2015 over 75 NGO partners will add active TB detection component into their service package.

• Expansion of NGO based active TB detection will reduce the spread of new TB cases and mortality among MARPs in Ukraine.