Improving TB Case Detection in high population ...

Improving TB Case Detection in high population density settings in Myanmar by establishing innovative links to private sector providers Population Services International (PSI Myanmar)

To change Photo Background and Rationale Tuberculosis (TB) is one of the major public health problems in Myanmar. Myanmar is one of the 22 TB high burden countries, one of 27 MDR-TB high burden countries and one of 41 TB/ HIV high burden countries in the world. Regarding these high burden of TB, PSI/Myanmar manages a franchised network of more than 875 Sun Quality Health private TB clinics nationwide and this project is “to increase early case finding of active, infectious pulmonary TB in in urban slum dwellers, and to place these patients on TB treatment according to national and international guidelines”.

Objectives and Targets

DESCRIPTION

Planned Activities

(1) To reach 480,000 people with interpersonal communications about TB, and to screen them all for TB symptoms according to a protocol agreed with NTP • To collect sputum in situ from approximately 19,200 symptomatic suspects, to provide free lab services, and to return results direct to suspects and collect further samples for testing • To refer sputum positive and sputum negative suspects to TB treatment services with a voucher that guarantees free diagnostics (including chest X-ray) and treatment (2) To establish a network of 500 informal health service providers in urban areas, trained to identify people with the symptoms of TB and incentivized to refer them to TB diagnosis and treatment providers. • Through this network, to refer 13,000 screened suspects to formal services with a voucher that guarantees free diagnostics (including chest X-ray) and treatment

Intervention 1: TB Outreach 1. Developing interpersonal communications tools and promotional items 2. Recruiting 60 IPCs 3. Training IPCs in interpersonal communications skills and basic TB knowledge 4. Producing interpersonal communication tools and promotional items 5. Field implementation 6. Collecting sputum samples from symptomatic suspects 7. Referring symptomatic smear negative cases for clinical examination and chest X-ray 8. Treatment at DOTS clinics . Intervention 2: Case finding and referral from drug sellers to Sun Quality Health TB providers 1. 2. 3. 4.

Advocacy meetings with drug sellers Training drug sellers Referring symptomatic cases for sputum examination and chest X-ray Arranging treatment at DOTS clinics

Current Achievement IPCs Over the course of November and December 2011 alone, IPCs’ health education reached a total of 9,785 persons and referred 306 TB suspect cases for sputum examination and 224 cases for chest X-ray . Among them, a total of 18 persons were found to be TB positive through sputum examination and 22 cases were found to be TB positive through chest X-ray. Pharmacies PSI’s advocacy with pharmacies proved to be successful with 58 pharmacies joining PSI’s network which referred 50 suspect cases for sputum examination and 4 cases for chest X-ray. Through active case detection provided through the pharmacy channel, three cases were confirmed with TB through sputum examination and two cases were confirmed through chest X-ray.

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