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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.

More and more patients with tuberculosis across the country are being screened for tuberculosis multidrug resistance, in the labs provided with modern equipment for rapid diagnosis of MDR-TB / XDR.

During July, it continued the rapid testing of TB patients in the laboratories of the PNPSCT network, equipped with modern diagnostic (national reference laboratories in Bucharest and Cluj and TB laboratories in Bacau, Brasov, Constanta, Craiova, Sibiu and Timisoara).
In total, in July, 1,327 people were tested within MGIT and LPA techniques; of these, 42 patients were found with resistant TB, including 15 patients with MDR TB.

The centralized data during March-July 2015 show that in 5 months only since eight laboratories in the country are carried out rapid testing for MDR TB using modern equipment procured under the project, 5428 people were tested. Of these, 333 patients were detected with resistant TB, including 122 patients with MDR TB.

Medicines for correct, complete and quality treatment of MDR TB, available for 200 patients

44 new patients with MDR TB were enrolled in the project in July, to receive correct, complete and quality treatment, adding to those already enrolled 138 patients by the end of June 2015. Currently, there are drugs available for the treatment of 200 patients. Medicines for the remaining 550 patients to be treated in the project will be available in approximately two months, after completion of quality controls and labeling exemption from approval by ANMDM.

Also in July, 27 of MDR project coordinators sent to the central team the databases updated with patients diagnosed with TB MDR / XDR and recorded during May – July 2015.

DOT and incentives for TB outpatients

In July, from 1723 patients considered eligible to be enrolled in the project, 409 patients were submitted signed consent forms, by 10th of June, and between June 11 to July 31, other 56 new patients were sent signed consent forms completed. Overall, the project enrolled 465 patients for receiving incentives (ie 31% of the 1,500 planned).
For patients eligible to receive social support adherence to anti-TB treatment administered according to the doctor’s recommendations throughout June, the project team has centralized the following information:
– 373 unique patients received social support so far in the project,
– cumulatively in July, June and May, vouchers were distributed to a number of 778 patients (172 in May, 249 in June, 357 in July). Of the 172 patients who received support in May, more than 91% (ie 158 patients) received vouchers for maintaining adherence in all three months.

By the end of July, 42 of MDR TB coordinators in Bucharest and the country received incentives for activities carried out in order to increase patient adherence to treatment, during April-June 2015.

Continue the training for the health professionals that are part of PNPSCT, in order to increase capacity to control the epidemic tubeculoza

Between 2nd – 4th of July, 2015 it was held a course for 25 health professionals in the field of respiratory medicine at Buzau. Lecturers were Dr. Luminita Palaghianu and dr. Emilia Tabacu. The course was attended by health professionals from Buzau and Vrancea counties.
In total, to date, 214 have been trained in the field of respiratory medicine by health professionals (109 nurses and 105 doctors), representing 36% of the proposed target of 600.
Also, on 2nd and 3rd of July was made a monitoring visit to Buzau, for the course held here.

Working on updating the national electronic database of PNPSCT

In July 2015, several working meetings were held with company representatives selected to provide services for updating and maintaining the national database of PNPSCT and were discussed the modules that require changes in line with the international recommendations in the field.

Steps to strengthen the capacity of preventing TB transmission in poor communities

On the 6th and 7th of July, the project team representatives attended the international seminar entitled „Services health for vulnerable communities”, along with representatives of Ministry of Health and five County Departments of Public Health of six Departments included in the project RO19.01.
The communication with experts appointed on completion of the course curriculum for community workers continued.
Also in July there were identified the two experts who will provide TOT course and the 12 representatives who will monitor the work of local officers and will prepare all community nurses in their communities.

The World Health Organization (WHO) will provide technical assistance to the PNPSCT

During July, the contract was drafted, for the World Health Organisation to provide technical assistance to the National Programme for Prevention, Surveillance and Control of Tuberculosis. The contract was sent to the office of the World Health Organizationin Copenhagen.

Expenditure for the period 1 to 31 July 2015 are shown in the table below: