Annual Report: Challenge TB – South Sudan Year 2

The program's primary focus in Year 2 was to increase case notification and improve treatment outcomes by supporting the expansion of quality and sustainable TB care services in the three states of Central Equatoria State (CES), Eastern Equatoria State (EES), and Western Equatoria State (WES). These states have large populations and a high burden of TB and HIV. In addition to expanding TB care services, Challenge TB supported the provision of TB services to internally displaced populations (IDPs), the United Nations Missions camps, commonly known as Protection of Civilian Sites (PoCs), and the expansion of quality-assured TB diagnostic services beyond the three states. Four community-based organizations (CBOs) were subcontracted to implement TB community activities in the four counties of Juba, Yei, Lainya, and the Greater Mundri. During Year 2, Challenge TB continued to support contact investigation in seven health facilities in five counties in South Sudan. A total of 1,654 index TB cases were registered, out of which 20.1% (333/1,654) households were visited and contacts were screened using standard tools and forms. Approximately 17% (476/2,824) of contacts screened were referred for TB microscopy, out of which 8% (37/476) were bacteriologically confirmed with TB through smear microscopy. Challenge TB also supported the development of a framework, "Tuberculosis Prevention, Care and Control among Refugees and Internally Displaced Populations in South Sudan," to ensure access to TB prevention, care, and control services at IDP camps in South Sudan. In collaboration with the National TB Program (NTP) and partners, Challenge TB trained 58 healthcare workers (HCWs) on TB diagnosis and case management at the POCs and IDP camp, procured and delivered lab equipment, and provided technical assistance to support the implementation of TB services. The conflict in July 2016, which began in Juba and spread to areas supported by Challenge TB, resulted in a massive displacement of the population and the disruption of many services, including healthcare. Despite the conflict, Challenge TB worked closely with partners International Medical Corps (IMC) in Juba PoC and Health Link South Sudan in Mingkaman IDP camp to implement TB activities in these two settings. Challenge TB's efforts in Year 2 contributed to improved contact investigation, provision of services to displaced populations, and the expansion of quality-assured TB diagnostic services. The program's focus on supporting the expansion of quality and sustainable TB care services in high-burden states and providing TB services to IDPs and PoCs helped to improve treatment outcomes and increase case notification.