December Monthly Progress Report USAID ERADICATE TB PROJECT

The project focuses on six provinces: Copperbelt, Central, Luapula, Muchinga, Northern, and North-Western. During the reporting period of December 1-31, 2019, data were collected from 249 health facilities across these provinces. TB testing efforts were a key focus area for the project. In December 2019, ETB recorded 9,252 individuals presumed to have TB and 9,616 individuals tested for TB in the laboratory, representing a 104% testing rate. The positivity yield was 6% in December 2019. Of the 601 individuals diagnosed with TB, 587 (98%) were initiated on treatment, an increased rate compared to November 2019 (90%). The project also supported community-based volunteers (CBVs) and TB focal point persons in tracing primary loss to follow-up (PLTFU) patients and linking them to treatment. The project also strengthened community activities to contribute to overall project screening efforts. Of the 1,272 patients notified by the project in December 2019, 449 (35%) were notified through community efforts. The positivity rate for samples collected via routine community activities was 9%. All 449 patients diagnosed with TB were linked to treatment and care (100% linkage). GeneXpert usage compared to microscopy in ETB-supported sites showed that GeneXpert accounted for 60% of laboratory testing in both November and December, despite a low supply of GeneXpert cartridges and continued power outages across the country. The project continued to support facilities to promptly re-channel referred samples to GeneXpert hubs with power supply. TB notifications in the six ETB-supported provinces showed a total of 1,272 TB patients were notified in December 2019, of whom 46% were bacteriologically confirmed and 54% were clinically diagnosed. Of the 1,272 TB patients notified, 813 (64%) were male and 459 (36%) female. The breakdown of the 1,272 TB patients notified by type of TB and type of diagnosis showed that 579 (45%) were bacteriologically confirmed pulmonary tuberculosis (PTB) patients, 585 (46%) were clinically diagnosed PTB patients, and 100 (<1%) were extrapulmonary tuberculosis (EPTB) patients. The project will introduce the use of the OneStopTB mobile clinic to enhance screening with Computer-Aided Detection for Tuberculosis (CAD4TB) automated digital x-ray in Copperbelt and Central provinces in February 2020. The project will also strengthen the referral between symptomatic screening and laboratory testing points to increase the proportion of presumptive patients' samples that are tested for TB in the laboratory.