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World TB Day 2011

World TB Day 2011. March 24, 2011 Mavuso Centre Manzini – Kingdom of Swaziland. Project 1 Background. MSF & MoH partner project in Shiselweni started in Nov 2007. Integrated TB – HIV project Project site : Shiselweni region (all MoH facilities) and communities

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World TB Day 2011

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  1. World TB Day 2011 March 24, 2011 Mavuso Centre Manzini – Kingdom of Swaziland

  2. Project 1 Background • MSF & MoH partner project in Shiselweni started in Nov 2007. • Integrated TB – HIV project • Project site: Shiselweni region (all MoH facilities) and communities • Project general objective: Reduce mortality & morbidity linked to HIV & TB

  3. Project 1 Background (2) SPECIFIC OBJECTIVES • Decentralisation of HIV and TB services all the way to all 18 MoH clinics (+ 4 others) • Improve the quality of TB care and treatment at secondary facilites • Improve diagnosis and treatment outcome for MDR TB • Enhance national capacity to respond to HIV & TB (DST survey carried out in 2009-2010)

  4. Project 1 Background (3) STRATEGIES • Decentralize services • Integrate into exisitng PHC facilities • Task shifting • Large scale involvement of PLWHA • Community activities for prevention & care 

  5. Project 2 Background • MSF & MoH partner project in Manzini Region started in 2010 • Mankhayane and NRL August 2010 • Matsapha site March 2011 • Integrated TB – HIV project • Project site: Manzini region • Project general objective: Reduce mortality & morbidity linked to HIV & TB

  6. Project 2 Background (2) SPECIFIC OBJECTIVES • Decentralisation of TB services all the way to 3 clinics in Mankhayane sub region • Provision of free flexible quality integrated HIV-TB services in Matsapha industrial area • Improve diagnosis and treatment outcome for MDR TB • Enhance national capacity to respond to TB (including MDR) – Improve NRL capacity for culture and DST

  7. Project Background (3) STRATEGIES • Decentralize TB services • Integrate into exisitng PHC facilities • Task shifting • Large scale invlovemnt of PLWHA • Community activities for prevention & care 

  8. Achievements Shiselweni Project Decentralisation of HIV & TB services • Reinforcement of 3 main TB clinics • All 18 MoH clinics integrated for HIV-TB care and treatment. All 18 accredited for TB initiation by NTCP • Decentralized management of MDR patients (currently 157 DR TB patients on treatment) • Patients support at clinic and community level through TB ECs and support groups • IPT available, ICF and IC measures in clinics (rehabilitations)

  9. Key successes • 3475 TB suspects detected in 2010 at the 2 Health centres and Hlatikulu hospital • 2369 TB suspects detected in PHCs in 2010 – from 144 in Q1 to 984 in Q4 • 2552 patients were enrolled into TB treatment in 2010 • 706 patients initiated TB treatment in PHCs in 2010 – sharp increase • In 2010, 1087 patients initiated IPT in PHCs of Shiselweni region (994 from June to Dec). 90% completed treatment • Improving treatment outcomes – 70% of new cases enrolled in 2008-2009 have successful treatment outcomes. • Better treatment adherence

  10. Major Challenges • Drug-resistance survey conducted in 2009-2010 showed that 7,7% of the new smear positive TB cases and 33,9% of the previously treated cases have MDR forms of TB respectively • Patients seeking treatment too late (particularly men) • More than 10% of TB patients die during the TB treatment and 10% default. • Drugs supply to clinics and drug management • Patients’ access to facilities remains problematic • Community mobilization for support to patients – key to adherence • Stigma attached to HIV and TB in communities • Diagnosis and treatment of MDR TB patients, and management of side effects • In spite of progress, still limited lab capacity – new TB lab Nhlangano

  11. Achievements Manzini Project • Mankayane TB treatment has been decentralized to 2 peripheral health units. • Mankayane is now officially accredited as a DR-TB centre. • MSF and MoH teams working hand in hand to treat TB and DRTB patients in the Mankayane sub region. • Matsapha: HIV-TB integrated clinic opened early March 2011 (soon officially opened)

  12. Conclusion • Encouraging results and achievements so far and improved collaboration especially at PHC level • All health workers must be on board for the fight against TB from SMOs to RHMs • Climate in health sector must be condusive to avoid dispersion and keep focus on patients

  13. Siyabonga

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