October- December 2014 Quarterly Report, USAID Malawi TB CARE II Project

The project maintained a focus on decentralization of TB services, including TB screening in pre-ART, ART, PMTCT, and ANC settings, and strengthening of TB/HIV collaboration and services. In the quarter under review, TB CARE II completed renovations of MDR-TB isolation rooms at Bwaila Hospital in Lilongwe, procured Fit Test kits, and trained 100 HCWs on the use. This brings the total number of fit test kits procured and distributed to all central hospitals and some district hospitals across the country to 11. TB screening in HIV settings continued to be an active focus of the project, especially in the district hospitals in TB CARE II supported districts. During the quarter under review, a total of 1648 TB cases were notified. Of these, 1,516 had known HIV results. TB CARE II continued collaborating with the Ministries of Education and Health to promote active TB screening among teachers and learners who are members of Teachers and Learners Living Positively (TLIPO). Training of trainers of these teachers will be conducted in Q2. The community-based TB service delivery systems also continued to be strengthened with the support provided to active Community Sputum Collection Points (CSCPs). In PY 5 quarter 1, CSCP volunteers continued conducting community awareness meetings in their respective catchment areas as part of their routine activities. A total of 1178 presumptive TB cases were identified through CSCPs. Out of these, 49 TB cases were confirmed. Laboratory diagnostic networks in impact districts were strengthened through joint supervisory and monitoring visits to 7 newly installed GeneXpert platforms in Blantyre, Kasungu, Mchinji, Lilongwe, and Nkhata-Bay district. A plan to strengthen the implementation of community-based MDR-TB was developed and endorsed by the NTP. TB CARE II supported the renovation of MDR-TB isolation rooms at Bwaila Hospital in Lilongwe. TB CARE II provided technical and financial support to NTP to carry out a verification and validation exercise in all health facilities nation-wide in the quarter just ended. The project also continued to enhance collaboration between USAID implementing partners through meetings with Dignitas International, Bridge II Project, and Ministry of Education. TB CARE II continued to provide technical support to the National Tuberculosis Program to improve TB and TB/HIV services in its 12 impact districts. The project maintained a focus on decentralization of TB services, including TB screening in pre-ART, ART, PMTCT, and ANC settings, and strengthening of TB/HIV collaboration and services. In the quarter under review, TB CARE II carried out joint supervision visits to 5 districts. TB CARE II provided financial and technical support to the NTP to carry out data verification and validation exercise in all TB registration sites in Malawi covering the period January to December 2014. The exercise was a success as all the planned TB registration sites were visited and data verified. The outcome of the exercise will help the NTP to report verified data to Global Fund as per reporting requirements. TB/HIV integration and collaboration with other stakeholders was at a peak in December, 2014. TB CARE II efforts to promote early TB screening, establish mechanisms for collaboration and coordination received national attention. TB CARE II was invited to present a paper on the theme "Better safe than sorry, screen for TB early, TB Treatment is free, Avoid being sick” at the annual general meeting for Teachers and Learners Living positively (T’LIPO). The delegates to the AGM learned about the relationship between TB and HIV and how to prevent the TB disease especially among People Living with HIV (PLHIV) also provided support to T’LIPO to disseminate TB/HIV integrated messages to their groups. TB CARE II participated in the 45th Union World Conference on Lung Health that took place in Barcelona, Spain from 28 October to 01 November, 2014. The project sponsored two NTP officers to attend the conference. TB CARE II made several displays and had a presentation on TB/HIV and Community Driven TB Solutions. The project conducted a joint GeneXpert supportive supervision to all GeneXpert platforms that were recently installed in the seven Health facilities across the country. TB CARE II also supported the roll out of new diagnostics and efforts to strengthen TB/HIV integration and health systems.