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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.

The provision of continuous, complete and quality treatment for 1 000 MDR/XDR TB patients

In October, the enrolment of patients continued in the two MDR TB centres in Bucharest and Bisericani and in the other TB facilities in the country involved in the project. As such, at the end of the month, a total of 744 patients were enrolled under complete, correct and continuous treatment.

As a result of the application submitted by the project team, the National Agency for Medicines and Medical Devices issued the special needs authorisation for the treatment scheme required for patients diagnosed with M/XDR TB. The medicines will arrive in the immediately following period.

The provision of integrated interventions for the prevention of TB transmission in poor communities and for the increase of treatment adherence

In October, a monitoring visit was conducted at the training session dedicated to community workers in Olt County, and 10 TB information, education and communication caravans were organized: 2 in Călărași County, 4 in Giurgiu County and 4 in Olt County. Through these caravans, 553 persons received information regarding tuberculosis, among them 133 Roma. So far, 8 795 persons, of whom 1 396 Roma, have received information throughout the project. The planning of the IEC caravans for November has been completed.

During this reporting period, 88 patients have been enrolled for the provision pf DOT, with a total of 739 patients enrolled at project level, of whom 97 Roma patients. The patients enrolled come from 212 localities in the country.

The establishment of a network of functional laboratories for the early detection of MDR/XDR TB

In October 2016, testing using rapid diagnostic techniques for MDR/XDR TB was conducted in 20 laboratories within the National Programme for Prevention, Surveillance and Control of Tuberculosis (NPPSCT) network: NRL Bucharest, NRL Cluj-Napoca, the TB laboratories in Bacău, Brașov, Constanța, Craiova, Sibiu, Timișoara, Iași, Baia Mare, Leordeni, Sf. Ștefan Hospital in Bucharest, Leamna, Călărași, Galați, Târgoviște, Drajna, Deva, Tg. Mureș and Focșani.

The summarized data related to the rapid testing activity carried out in the TB laboratories within the project in October 2016 show that, among the patients tested, 658 were detected with sensitive tuberculosis, 37 with MDR tuberculosis and none with XDR TB.

In total, since March 2015 and until the end of October 2016, of the 26 179 individual patients submitted to rapid diagnostic testing, 10 370 were detected with sensitive TB, 840 with MDR TB and 89 with XDR TB.

The procurement of two other Genexpert systems, one MGIT equipment and six centrifuges has been provided for, to take place in the following period. In October 2016, the summarized procurement procedure for the Genexpert and MGIT systems is underway, namely at the stage when the submitted tenders are being analysed. Technical specifications have been completed and the summarized procurement procedure will be launched the following month.

Also, the procurement of two IT servers required for the administration of the software for the national registration, monitoring and reporting of TB/MDR TB cases has been provided for. In October 2016, the legal procedure for the procurement of the 2 servers is underway.

The provision of directly observed treatment and of the incentives for TB patients treated in outpatient facilities in order to increase treatment adherence

At the end of October, the database comprising the patients enrolled in the project for social vouchers intended to increase treatment adherence included 1 685 individual patients, of whom 1 284 met the eligibility conditions to receive social vouchers. Of them, 411 patients have been enrolled and have been provided with support under the project for approximately one year, while 223 patients have completed the treatment.

Other activities carried out in October

Five TB Infection Control training sessions were organized in the counties of Dâmbovița, Sălaj and Iași.

Activities continued for the review of the Practical Approach to Lung Diseases national guide, which will establish the algorithm for the identification of TB suspects in the general population, the specialist referrals, the involvement of the primary care network in tuberculosis care in Romania.

Work has been undertaken to nail down the patient brochure and the organization of peer-support volunteer network.

A health communication workshop was organized in Sinaia (12-15 October), with 24 participants.