Quarterly Monitoring Report: Challenge TB – Botswana Year 2, October-December 2015

The program's workplan for the period of October 2015 to September 2016 focuses on improving TB diagnosis, treatment, and prevention services. One of the key achievements of the program during the quarter of October to December 2015 was the completion of a GxAlert landscape analysis. The analysis identified several operational recommendations to improve the TB information system, including the need to keep the installation process uniform across sites, connect GxAlert to OpenMRS and the Data Warehouse, and deploy nationwide anti-virus to PCs. The program also made significant progress in supporting the Global Fund implementation in Botswana. The grant-making process was completed during this quarter, and the country was granted US$ 27,043, 807 for a joint TB/HIV concept note. The grant signing is scheduled for the 1st week of February 2016. In addition, the program provided mentoring and supportive supervision to multidrug-resistant TB (MDR-TB) sites in Nyangagbwe Referral Hospital, Sekgoma Memorial Hospital, and Letsholathebe II Memorial Hospital. The visiting team identified several challenges, including the need for improved infection control and the delay in moving to the new MDR-TB clinic at Jubilee hospital. The program also conducted mentoring and supportive supervision at GeneXpert and TB microscopy sites in Greater Francistown and Tutume districts. However, the GeneXpert utility was not optimal due to poor placement of the GeneXpert platform and the lack of an air-conditioner in the lab. The National TB Reference Laboratory (NTRL) is still facing challenges with the provision of services to the nation with respect to culture and drug susceptibility testing. The lab has been closed due to the loss of its capability to work under negative pressure, which has compromised the diagnosis and routine patient monitoring for drug-resistant TB in the country. The Ministry of Health and Challenge TB are currently sourcing out funds to effect the refurbishment of the lab. The program's Year 2 activity progress report highlights several planned key activities, including the performance of an internal audit of the current C/DST and M/DST with recommendations for improvements to provide quality and efficiency in testing. However, the NTRL has not yet been refurbished, and the audit results are not available for this quarter. The program is expected to complete the refurbishment of the lab by the 3rd quarter of APA2, although it is solely dependent on the availability of funds.