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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.

NPPSCT national database update

In December, the Services Agreement for the update and maintenance of the national database for the National Tuberculosis Prevention, Surveillance and Control Programme (NPPSCT) was monitored with regard to the modules that require amendments in accordance with the international requirements and recommendations in the field. The reviews covered the nomenclatures including physicians who provide services in the TB surveillance network, updated medicines lists, genetical laboratory tests available, user manuals, testing scenarios for the functionalities of each type of user. 80% of the national database has been updated.

The provision of continuous, complete and quality treatment for 1 000 patients with multidrug-resistant or extensively drug-resistant tuberculosis (MDR/XDR TB)

In December, the enrolment of patients continued both in the 2 MDR TB centres in Bucharest and Bisericani, as well as in the rest of the country, which resulted in 809 patients enrolled under complete, correct and continuous treatment in the project at the end of the month.

 

Monitoring visits continued in the dispensaries, laboratories and hospitals in the counties of Arad, Prahova, Brăila, Timiș, Teleorman, Olt, Mureș and Constanța.

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

In December, 14 caravans were organized for the information and education of the public with regard to tuberculosis: 8 in Bacău County and 6 in Olt County. These caravans were attended by 717 persons, of whom 97 Roma. So far, a total of 10 673 persons have received information under the project, among them 1 575 Roma. The IEC caravans for January were planned.

By the end of December, 1 820 gift vouchers had been distributed to community nurses and sanitary mediators who organized IEC caravans between January and November. Also, 17 235 social vouchers had been distributed to patients. At the end of this month, a remaining 266 social vouchers were still being distributed to patients.

For the provision of DOT, a total of 908 individual patients were enrolled, of whom 141 Roma. 58 patients were enrolled in December. The DOT provision activity involved 304 DOT supporters who monitored patients from 8 counties and to whom 15 960 gift vouchers were distributed in the period January-November.

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

In December, testing using rapid diagnostic techniques for MDR/XDR TB was conducted in 20 laboratories in the 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 carried out in the TB laboratories under the project during this month show that, out of the tested patients, 446 were diagnosed with sensitive tuberculosis and 21 with multidrug-resistant tuberculosis.

The data summarized since the commencement of the project show that 29 233 patients were tested in the laboratories referred to above using rapid diagnostic techniques, and 11 530 of them were detected with TB, 899 with MDR TB and 91 with XDR TB. The centralised procurement for the two Genexpert systems, the MGIT equipment and the six laboratory centrifuges established to be procured during the project extension period was completed in December, and the equipment has been accepted and installed in the TB laboratories.

Also in December, the documents were drafted and the procurement procedure was launched for a LPA laboratory equipment. Also, in order to ensure the continuity of the rapid testing activity in the TB laboratories, another 5 500 MGIT tests (5 000 cultures, 500 first line ABG) were procured and distributed to the TB laboratories in December 2016.

The procurement of two IT servers required for the administration of the national registration, monitoring and reporting of TB/MDR-TB cases has been provided for, to take place in the project implementation extension period (1 April 2016 – 31 March 2017). In December, the procurement procedure for the two servers was concluded and the supply contract was signed.

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

At the end of December, the database comprised 2 078 patients enrolled both for treatment adherence and for treatment, and 1 653 patients enrolled for treatment adherence. Of these, 1 331 met the eligibility conditions to receive social vouchers for the increase of treatment adherence. Of these, 396 patients have been enrolled and have been provided with support under the project for approximately one year, 783 patients continue the treatment, while 311 patients have completed the treatment.

Other activities carried out in December

Three TB Infection Control training sessions were organised in the country, in the counties of Călărași 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.

In December, the patient brochure was finalised and the organisation of the peer-support volunteer network continued.

The promoter organised a press conference on 21 December to launch the information material (the brochure) for TB patients.