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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.

All counties were assigned for sending samples to the labs equiped through the project, for rapid diagnosis of TB MDR / XDR

In May 2015, the TB patients’s testing through rapid MDR / XDR TB diagnosis techniques continued in the PNPSCT’s network laboratories in Bucharest, Cluj, Bacau, Brasov, Constanta, Craiova, Sibiu and Timisoara – the labs were equipped with appropriate equipment and supplies. All counties were assigned for sending samples to these laboratories, thereby ensuring patients across the country access to rapid diagnosis. By the end of May 2015, 2,186 patients had been screened (of which 1341 patients only in May); 195 patients were found to have TB resistance, of which 78 have MDR TB.

The number of patients enrolled in treatment in the project increases – 101 people, up to May 31, 2015

33 more patients with MDR TB were enrolled in the project in May, in addition to the 68 enrolled until the end of April to receive complete, continuous,  quality treatment. The total number of MDR TB patients enrolled for getting medication is 101.

The inclusion of patients in treatment is based on the MDR TB Commission’s decision as a result of eligible patient dossier and the patient’s signed consent sheet submission to the Commission. By the end of May the information was collected in Bucharest and in all counties. The MDR TB experts continued the analysis of the project database and identified 600 patients with resistant tuberculosis that could receive treatment through the project. In the next period, this information will be communicated to the MDR coordinators who will supervise the process of forwarding the patient files to the  two MDR TB committees, in order to enroll them in treatment.

During May, the dossier for authorization of special needs for medication has been deposited at the National Medicines Agency,   and the correspondence with GDF and IDA, concerning the next disbursements of drug deliveries in the country, and  the expiration deadlines for the  drugs that will be delivered, was continued.

The process of data centralizing and eligibility analysis for social support was completed and the incetivising program was initiated in order to increase the adherence to treatment

After centralizing the databases  that the MDR coordinators received from all over the country until the end of May, regarding patients with resistant tuberculosis or sensitive TB patients with high risk of mortality, treatment failure or abandonment, , 1746 patients were considered eligible to be enrolled in the project. According to the methodology, once considered eligible to benefit from social support, the patients must submit signed consent sheets. 363 patients from 1746 submitted their signed consent sheets by the end of May.

For patients eligible to receive social support for anti-TB treatment adherence administered according to medical recommendations throughout April, the project team has centralized the following information:

– 160 patients were eligible to receive social vouchers – meaning 160 patients who completed and signed consent records up to April 10, 2015 (those who signed after this date will receive the tickets the following month).

– The 160 patients received social support in May in order to keep treatment adherence, status confirmed by the patient’s treating physicians and communicated by the MDR TB coordinators –through  completing and signing the monthly centralizers which have been forwarded to the RAA Foundation’s regional coordinators during the month.

On 9th and 10th of May, the project team organized, in Bucharest, the first meeting of the national MDR TB coordinators. The event was attended by 35 MDR coordinators and the topics were presented by lecturers from the « Marius Nasta » Institute and Romanian Angel Appeal Foundation.

During the meeting, the mobile phones and HEPA masks for the voluntary activity performed by MDR coordinators in order to increase patient adherence to treatment, were also distributed.

For the MDR coordinators who could not be present at the first meeting, monitoring and evaluation visits were organized, in order to inform and train them. By the end of May, the RAA coordinators visited Neamt, Cluj, Salaj, Hunedoara, Satu Mare and the Ambulatory of Pneumology of District 1, Bucharest.

Providing the laboratories in the country with MDR rapid diagnosis and IT equipment  

During this period, the supply the laboratories with GeneXpert equipment (8 devices) and Versatrek equipment (3 devices) continued . For GeneXpert equipment procurement the contract was signed with the company declared the winner of the selection procedure, as for the Versatrek equipment and supplies, the documents necessary for the selection process were finalized and the procedure will be officially launched on specialized sites after approval  of the unit investment list for 2015, by the Ministry of Health.

Other TB laboratories in the country will be equipped with protective hoods (44 labs), LED microscopes (10 labs), IT equipment and vehicles.

For the purchase of 44 protective hoods and 10 LED microscopes the technical specifications were developed in order to launch the selection procedure of the supplying company and the supplier selection procedure will be launched when the necessary funds will be available.

For the purchase of IT equipment and vehicles, the technical specifications development was completed and also the lists of TB units that need to be equipped through project. The procedure for selecting suppliers will be released upon receipt and approval, by the Ministry of Health, of the list of investment funds.

Also in May:

– Two courses for health professionals in the field of pulmonology were held in Timisoara (15.05 – 17.05.2015) and in Sibiu (28.05 – 30.05.2015), in order to increase the  containment of TB in Romania

– A work meeting of  the representatives of the Project Promoter, the RAA Fondation and the World Health Organization was held for arranging the procedure of contracting the WHO  and the joint missions financed by the Global Fund and Norwegian Fund.

– The first training course on health communication was held, meant to create new trainers

– The projects’s presentation brochure’s layout was finalized.

Expenditures for the period 1 to 31 May 2015 are shown in the table below:

No

BUDGET LINE

Value of expenses

in M10

1

Human Resources

265,737.00

2

Travel Costs for the staff and volunteers

1,397.64

3

Consumables

2,284,665.88

4

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

0.00

5

Other costs related to the services supply to the beneficiaries

15,864.94

6

Project Communication and Promotion

0.00

7

Bilateral activities

0.00

8

Other subcontracted activities

98,204.09

9

Indirect Costs

4,151.46

10

Unexpected Costs

0.00

Total

2,670,021.01