Kidus Petros Specialized Hospital, the national center of excellence for DR-TB care, in collaboration with Urban TB LON II Project, supported by the US government has stepped up its DR-TB Prevention and care services by conducting retrospective household contacts screening using AI-Powered CXR systems and initiation of DR-TB Preventive Therapy (DR-TB TPT) for eligible household contacts of DR-TB patients treated at the hospital during the past two years.
In just 7-days screening activity, total of 100 registered household contacts of DR-TB index cases registered over a two-year period (2016 EFY – 2017 EFY) were screened for TB using AI-CXR systems, and tested with GeneXpert as per the latest national guidelines recommendations. No TB/DR-TB case was detected among these household contacts. After careful assessment and counselling of the household contacts for DR-TB TPT initiation, the hospital has initiated the 6-months daily Levofloxacin (6Lfx) regimen for 20 contacts immediately, linked the clients to nearby health centers in Addis Ababa city administration for adherence support and closer follow ups.
This targeted prevention work is an essential component of the national DR-TB elimination initiative, especially as Ethiopia’s successful removal from the WHO’s global list of high Multidrug- and Rifampicin-Resistant TB (MDR/RR-TB) burden countries in 2020 is a testament to its intensified national TB control efforts, prominently featuring targeted case finding and prevention.
The main challenge faced was the limited feasibility of the retrospective approach, as many contacts did not present for screening. Moving forward, the hospital with continued support the Urban TB LON II Project plans to implement an active and prospective household contacts screening strategy with the aim of getting all household contacts of newly registered DR-TB patients screened within 7 days of index case registration, and immediate provision of TPT targeting household level DR-TB elimination. The project will continue to support similar activity of first retrospective contact screening and TPT provision at ALERT Comprehensive Specialized Hospital in Addis Ababa to clear the backlog of non-screened contacts of DR-TB patients treated at the hospital, followed by a shift towards a regular, prospective approach to enhance the effectiveness of DR-TB contact screening efforts nationwide.
