Globally 1 in 3 people are infected with tuberculosis (TB) of which 1 in 10 will go on to develop TB disease during their lifetime. In 2013, there were 9 million new cases but consistently 3 million people were not diagnosed, treated, or officially registered by national TB programmers (NTPs). Many of those missed by the NTPs will die or follow ineffective treatments and most will continue to infect others. Among those missed are those most vulnerable to falling ill with TB including the very poor and/or malnourished or undernourished people, people living with HIV/AIDS, children and women, migrants, prisoners, refugees and internally displaced persons, miners, the elderly, ethnic minorities, indigenous populations, drug users and homeless persons. Every year, on the 24th March, the world marks World TB Day (#WTBD2015) to mobilize political and social commitment for further progress towards eliminating TB. This year the Stop TB Partnership continues for a second year its campaign to reach the 3 million people missed ( #ReachTreatCureEveryone)
Project Lead(s): Daniel Datiko
Tuberculosis (TB) is a major public health problem worldwide, with the highest burden in low-income populations. While TB in children is common, its diagnosis is difficult in low-resource settings.
A community-based project was initiated to increase the number of children diagnosed with TB through a combination of community-based active case-finding, pooling of multiple samples and testing with a single test (Gene Xpert) to increase the yield and diagnostic access for TB in a high-burden setting.
Symptomatic children were examined and referred to the nearest health centre for X-rays, and – following international World Health Organization (WHO) guidelines – were offered Gene Xpert MTB-RIF testing, if available.
Because testing only one specimen with Xpert in children results in identifying only a small proportion (typically 20%) of patients with a positive result, pooling at least two samples (to be tested together with one Xpert cartridge) was evaluated to see if it would increase the yield of children confirmed to have TB, compared to using smear microscopy.
Households with known index cases were identified in the districts of the Sidama zone in Southern Ethiopia. They identified 350 children from the community and collected 235 sputum samples, 109 gastric aspirates and 7 samples for fine needle aspirate (FNA).
Children with enlarged lymph nodes had FNA at the University of Hawassa
For more Click https://www.grandchallenges.ca/grantee-stars/0252-01/
Health extension workers (HEW) in Ethiopia occupy a unique position by providing a vital link between communities and the health sector. The front line of Ethiopia’s primary health system, HEWs shoulder the tremendous responsibility of providing services to families and communities. They also transmit information to higher-level facilities to ensure appropriate care for patients and adequate resources for treating them. for more see the link below.
By Rosalind Steege
The European Commission funding of the REACHOUT project may have officially come to an end, but the impact of the work and its legacy will surely live on. This became apparent to me when I was fortunate enough to visit the REACH team in Ethiopia for the project’s final dissemination meeting. REACHOUT has been working for the past five years in Shebedino district just outside of Hawassa.
It had been a year since my last visit and the road from Hawassa to Shebedino (where the project was implemented) is still being worked on, it makes for a strenuous journey as stretches of new tarmac are interspersed with patches of rubble that would challenge even the best suspension mechanisms. Over time of course, piece by piece, the rubble will be filled in until inevitably one 25km swathe of smooth tarmac will connect the two and greatly improve the efficiency (not to mention comfort) of the journey. Travelling this bumpy road on the way to visit the health centres in Shebedino, I couldn’t help but reflect on how the incremental step by step approach they have taken to building the road, is not dissimilar to the approach REACHOUT has taken with its Quality Improvement (QI) cycles, where QI teams use a PDSA (plan, do study, act) approach resulting in continuous incremental improvements that expands the overall quality of health service provision. for more see the link below
Community health workers—known as health extension workers in Ethiopia—have teamed up with motorbike riders to dramatic effort in Ethiopia’s Sidama Zone, finding double the number of people with tuberculosis (TB) compared to a previous period and increasing their chances of survival.
The project, funded by the Stop TB Partnership’s TB REACH initiative and implemented by the Southern Region Health Bureau and the Liverpool school of Tropical Medicine (LSTM) in collaboration with the Ethiopian Ministry of Health and the Global Fund, engaged with some 1100 health and community workers to bring TB diagnosis, treatment and information materials to rural areas that previously had limited access to healthcare services. Working with motorbike riders, who play a supervisory role, the community health extension workers formed a bridge between these rural communities and far away healthcare centers. For more Click here