Peninah Wanjohi

EXPANSION OF TB-DOTS PROJECT FOR BULOBAZI DISTRICT

TB Globally•2nd greatest killer after HIV/AIDS.•More than 14 million people live with TB.•1.7 Million deaths in 2013• Over 95% of deaths occur in LMIC.• Increase in the number of people with MDR-TB•MDG: Reverse the spread of TB by 2015.•Between 1990 and 2013 45% decrease in the TB death rates.

Profile of Country X•Low middle income country.•Burden of disease is high.•Deteriorating socio-economic conditions•Causes of deaths: poverty related infections•TB incidence rate increased from 51/100,000 in 1990 to 205/100,000 in 2001

•75% morbidity and mortality occur for people aged 15-45years.

Strengths of TB Program

•Recognition and existence of the TB DOTS program

•Rise in the notification trends

• Increase in sputum negative cases

•90% immunisation coverage

Weaknesses of the TB program•Poor case detection and case defaults• Inactive case findings.•Limited availability of resources and infrastructure

•Lack of trained personnel•Lack of data specific to Bulobazi District•No contact tracing •Lack of community level involvement•No collaboration between traditional healers, village doctors and medical doctors

TB programOpportunities•Potential funding

•Government involvement

•Set out strategies

•Existence of NGOs

Threats•HIV/AIDS•Malaria•Diarrhoea•Poverty•Taboos and stigmatisation

•Poor sanitation

Plan ProposalAim: To improve the quality of TB care by 70% in Bulobazi district by 2016Objectivesa) To increase the rates of case detection by 50%

and reduce case defaults by 60%b) Increase and sustain access to good quality

health care services by engaging all care providers and community

c) To empower the people of Bulobazi with TB and, encourage community involvement and partnership

Activitiesa) Equip the health facilities with trained

personnel and modern infrastructure.b) Reinforce the implementation of the

national standards by all health care workers in accordance with the international guidelines.

c) Expand the treatment outlets in the poorest rural urban settings.

Activities• Ensure there is a reliable system of procurement and distribution of all the essential anti TB drugs to all health facilities.

•Incorporate HIV/AIDS services together with TB services.

•Increase community involvement and participation

References• Dye, C et al. (2006) Disease and mortality in Sub Saharan Africa: TB.

2ND edition. US national library of Medicine. Available on: http://www.ncbi.nlm.nih.gov/books/NBK2285

• World Health Organisation. 2006. THE stop TB STRATEGY: Building on and enhancing DOTS to meet the TB-related Millennium Development Goals. [Online]. [Accessed 19 November 2014]. Available from: http://whqlibdoc.who.int/hq/2006/WHO_HTM_STB_2006.368_eng.pdf?ua=1

• partnership, s.T. 2012. Stop TB partnership: Operational Strategy 2013-2015. [Online]. [Accessed 19 November 2014]. Available from: http://www.stoptb.org/assets/documents/about/OperationalStrategy2013-2015.pdf