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Improving the health of the population in Romania by increasing TB control

Project financed by the Norwegian Grants 2009 - 2014, within the RO 19 - Public Health Initiative.

Courses for healthcare professionals, to increase skills in TB control

During June 2015, five courses for health professionals in the field of pneumonology were held in Ploiesti (05.06 – 06.07.2015 for doctors in Ploiesti), Constanta (05.06 – 06.07.2015 for doctors in Constanta), Timisoara (12.06 – 14.06.2015 for doctors from Timis county and in Caransebes), Pitesti (19.06 – 21.06.2015 for doctors Dambovita and Arges counties), Cluj-Napoca (26.06 – 06.28.2015, for doctors from Cluj and Bistrita in Nasaud).

165 health professionals were trained in the field of respiratory medicine until now, within the project, through 7 training sessions. 117 of the professionals were trained in June.

Also in June it was completed the process of collecting the documents necessary for the conclusion of contracts for trainers courses, for 600 doctors and nurses working in PNPSCT network.

TB patients testing across the country, for rapid MDR TB diagnose

The data corresponding to the testing activity in the 8 laboratories equipped by the project, shows a total of 1,722 patients tested during June 2015, with the LPA and MGIT equipment. 63 patiens were found with resistant TB, including 22 with MDR TB.

Since March to June 2015, 3937 patients were screened within the project; 282 patients were found to have resistant TB, of which 106 have MDR TB.

Complete, continuous and quality treatment for patients with MDR TB

In June 2015, 38 more patients were enrolled in order to receive treatment for resistant tuberculosis, in addition to the 101 included up to May 31, in total being enrolled 139 patients with MDR TB.

By the end of June, the MDR TB project experts completed analysis of databases of all 41 counties and 6 districts of Bucharest. Of all cases analyzed, 422 were considered eligible and proposed to be communicated to MDR TB coordinators whose role is to ovesee the filing and forwarding of the relevant cases towards the two MDR TB committees, for enrollment in treatment.

The project’s team together with the MDR TB experts continued tu provide the MDR coordinators and physicians, information and clarifications about the  of cases forwarded to the MDR TB commission and also useful information about medication orders and stock management of anti-TB drugs.

During the current month , the last batch of drugs was received , part of the initial order (for the first 200 patients). The project team continued the correspondence with GDF and IDA regarding the next medication delivery, and the expiration deadlines for the other drugs that still need to be delivered.

DOT and incentives for MDR TB outpatients, in order to increase treatment adherence

In June, the regional coordinators sent to the MDR TB coordinators the latest database of patients diagnosed with resistant TB (RR, MDR-TB, XDR-TB) or sensitive TB and with a high risk of mortality, failure or treatment abandonment. The data were analyzed by expert physicians who made recommendations for enrollment.

Of the 1706 patients considered eligible to be enrolled in the project, 401 records submitted signed consent by the end of the month.

For patients eligible to receive social support for adherence to TB treatment administered under medical observation, throughout May, the project team has centralized the following information:

– 246 unique patients received social support so far in the project, status confirmed by treating physicians and comunicated by the MDR TB coordinators.

– Cumulatively, in June and May, tickets have been distributed to a total of 405 patients (166 in May and 239 in June), of whom 161 patients received vouchers for maintaining adherence in both months.

Also in June:

– For the process of updating the national database to be in line with TB WHO recommendations, the project’s team asked for technical assistance from the ECDC (the appointment of an expert in epidemiological surveillance for a mission of at least 3 days). According to the ECDC Director’s answer, the appointed expert is Vahur Hollo and the mission will take place in the next period.

– Preparations were made to finalise the signing of the contract with the World Health Organization and an official address was sent to ANRMAP to ask the opinion of the Agency on the OUG 34/2006 except for direct contracting of the World Health Organization.

– The project’s presentation brochure was printed, both in Romanian and English.

Expenditures for the period 1 to 30 June 2015 are shown in the table below

No

BUDGET LINE

Value of expenses

in M11

1

Human Resources

296,663.22

2

Travel Costs for the staff and volunteers

5,137.03

3

Consumables

0.00

4

Investigation Costs (under the upper limit established for each project)

0.00

5

Other costs related to the services supply to the beneficiaries

165,133.00

6

Project Communication and Promotion

0.00

7

Bilateral activities

0.00

8

Other subcontracted activities

51,899.12

9

Indirect Costs

18,382.63

10

Unexpected Costs

0.00

Total

537,215.00