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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.

Strengthening the Capacity of the National Programme for Prevention, Surveillance and Control of Tuberculosis to control the TB epidemic

Four training courses were organized in November for the medical staff in order to strengthen the capacity of the National Programme for Prevention, Surveillance and Control of Tuberculosis (NPPSCT) epidemic. The courses were organized in Bacau, Tg. Mures, Galati and Bucharest, and were attended by 85 participants. Overall, by the end of November, 508 health professionals were trained within this project. There were two monitoring visits, with courses organized at Galati and Bucharest, and the course planning was updated for the November 2015 – January 2016 period.
Documents were drafted for the procurement of services for training program evaluation and the panel of experts who will be invited to send their bid was selected.

Rapid testing of patients for Multidrug Resistant and Extensively Resistant Tuberculosis (MDR TB and XRD TB)

Two new TB laboratories – in Iasi and Leordeni – have started their activity of rapid testing within the project, completing the NPPSCT network of laboratories that have rapid diagnostic techniques for MDR TB and XDR TB in Bucharest, Cluj, Bacau, Brasov, Constanta Craiova, Sibiu, Timisoara. In November, in these modern equipped laboratories, 1,760 people have been tested, of which 484 have been detected with sensitive TB and 52 people with MDR TB.
In total, from March until the end of November, 11,406 patients have been tested in NPPSCT labs. A quarter of them (2,853 people) were detected with TB, 258 with MDR TB, and 4 with XDR TB.

Continue the work for the development of a functional laboratory network for early detection of MDR / XDR TB

The contract for the GeneXpert equipment procurement was signed and the laboratories in the country where it will be put into use were designated: Iasi, Timisoara, Leordeni, Craiova, Constanta, Cluj-Napoca, Brasov, Baia Mare. The persons responsible to work with the new equipment will be trained in this regard in December, 14th to 21st.
Regarding the acquisition of the 44 safety cabinets for laboratories, the centralised procurement procedure is in the bid evaluation stage. For the procurement of the 10 LED laboratory microscopes, the supplier selection procedure was completed, and the winner company was named. Next, the supply contract will be signed.
This month, the 9 vehicles procured under the project for transporting samples to rapid diagnosis laboratories were registered and sent to the designated TB units: Timisoara, Craiova, Calarasi, Constanta , Iasi, Bacau, Cluj-Napoca and Leordeni. One vehicle was assigned to NRL Bucharest, at the “Marius Nasta” Institute for Lung Diseases.
Three laboratories – NRL Bucharest, NRL Cluj-Napoca and LRR Galati – will receive Versatrek equipment, as stipulated in the contract signed in November with the company that won the procurement procedure. The equipment was received and shall arrive in laboratories between 3rd and 10th of December, when it will be put into operation and the staff will be trained to use it.

Ensuring the correct, complete and quality treatment of the patients enrolled and of those who receive incentives for maintaining adherence to treatment

Three more MDR TB patients were enrolled in treatment in November, and the total number of MDR patients enrolled since the beginning of the project is 292. Other 63 patients received the recommendation to be enrolled in treatment, after doctors from MDR TB committees analysed and discussed 111 new medical records.
In November, out of the 1,799 patients considered eligible to be enrolled in the project to receive incentives, 614 had signed consent forms until October 10th. In addition, 23 new patients had signed consent forms between October 11th and November 30th. Overall, 628 patients are enrolled to receive incentives within the project.
By the end of November, 561 unique patients had received social support to maintain adherence to treatment, as confirmed by the treating doctors.

Providing integrated interventions to prevent transmission of TB in poor communities and to increase treatment adherence

In November, the centralizing of the databases of TB patients from the six counties involved in the project was  finished. 680 patients were identified for enrollment, as follows: 206 in Botosani County, 115 in Giurgiu County, 112 in Calarasi County, 107 in Gorj County, 79 in Neamt County and 61 in Dolj County.
Also, work has been done to prepare three meetings with the participation of Local Health Assistance services and Health Ministry. They are about to take place during December in Botosani, Neamt and Dolj.

Other November activities

The procurement procedure of the UV lamps continued.
Educational materials for TB infection control course for TOT have been prepared and the training was organized.
In November, the discussions with the WHO for programming the technical assistance missions for next year started  by identifying and prioritizing NPPSCT periods and experts to carry out those missions.
Between 18 and 21 November the communications training session for health workers was organized, attended by 21 health professionals from NPPSCT network.