Quarterly Monitoring Report: Challenge TB - Afghanistan Year 2

The project's primary objectives included expanding Directly Observed Treatment, Short-course (DOTS) to densely populated urban areas and remote regions, enhancing healthcare settings, and increasing healthcare staff capacity. To achieve these goals, CTB collaborated with the National Tuberculosis Program (NTP) and other partners to implement DOTS expansion to 14 out of 15 provinces through sub-contracts with Basic Package of Health Services (BPHS) implementing organizations. The project also focused on providing safer healthcare settings for healthcare workers, clients, and communities by implementing TB Infection Control (TBIC) activities in 206 health facilities, including 10 additional facilities during the first quarter of Year 2. The project's training efforts resulted in the initial training of 237 male and 42 female public and private healthcare staff from five provinces, with a total of 279 staff members receiving refresher or initial trainings. This capacity-building initiative contributed to a 10% increase in presumptive TB patient identification, a 9% increase in bacteriologically confirmed pulmonary TB, and a 15% increase in all forms of TB case notification compared to the previous quarter. CTB's support to the NTP and BPHS implementers led to the identification and symptomatic screening of 10,834 individuals in close contact to index TB cases. Of those screened, 1,852 individuals were identified with presumptive TB and tested for pulmonary TB, resulting in the diagnosis of 159 people with all forms of TB and 97 bacteriologically confirmed pulmonary TB cases. The TB case notification for all forms of TB among contacts of bacteriologically confirmed TB cases in Afghanistan was 1,468 per 100,000 contacts to index TB cases. The project's efforts to enhance detection, diagnosis, and treatment amongst children showed significant improvements, with a 28% increase in household contacts registered and screened for TB, a 55% raise in household contacts tested for TB, and a 31% improvement in child identification as contacts to index TB cases. The total number of children identified as contacts increased from 5,586 in 2014 to 7,309 in 2015, with 1,846 children under the age of five being identified as contacts and 1,440 put on Isoniazid Preventive Therapy (IPT). The project's achievements in TB case notification were substantial, with a 56% improvement compared to national case notification of 119 per 100,000 population. The TB case notification for new bacteriologically confirmed TB cases and all forms of TB cases was 78 and 186 respectively per 100,000 population, demonstrating a significant increase in TB case detection and reporting. The project's collaboration with the NTP and other partners resulted in the implementation of various activities, including the expansion of DOTS, TBIC, and contact investigation. The project's efforts to enhance detection, diagnosis, and treatment amongst children showed significant improvements, with a substantial increase in household contacts registered and screened for TB, household contacts tested for TB, and children put on IPT.