Quarterly Report: July-September 2011

The project's overall work plan completion was 33% as of the end of September 2011. Technical areas with notable progress included Universal and Early Access, Infection Control, and Health Systems Strengthening. In the Universal and Early Access technical area, the community involvement model of health area IV of Santo Domingo was consolidated and expanded to areas V and VIII. The Elias Piña Province, bordering Haiti, began implementing the model, with plans to establish a referral system for TB suspects. Pharmacies and shopkeepers, known as colmados, contributed to suspect referral and case detection, with 100 referrals by pharmacies and 30 referrals by colmados. In the Infection Control technical area, 100 persons were trained in infection control in all health facilities. Plans were revised and recommendations made to implement physical modifications in health facilities. The National IC committee will be established, including all IC experts at the national level. The Health Systems Strengthening technical area focused on improving TB timely diagnostics and notification by private health services, particularly in zona franca factories, independent medical cabinets, and private clinics. A TB awareness session was held at the "Balic Doominicana" factory, resulting in the detection of 15 suspects. Training was provided to personnel in health services to register referred suspect cases from the industrial zone. The project also made progress in the PMDT technical area, with the purchase of 3 GeneXpert machines agreed upon and the kit of reagents financed by additional funding pledged for the extension of TB CARE until the end of 2012. Design of materials for adherence to treatment in MDR patients was in progress, with plans to validate materials with patients and health personnel. In the Health Systems Strengthening technical area, two new Stop Alliances at municipal level were formed in Monte Plata Province, and a neighbourhood committee was established in Area VIII of Santo Domingo. All Stop TB alliances were implementing activities according to their plan, which they elaborated with community members, services, and the KNCV team. The project's quarterly technical outcome report showed progress in several areas, including the reduction of delays in TB diagnosis, involvement of pharmacies and shopkeepers in detection and early referral of suspects, and the implementation of infection control measures in health facilities. However, challenges and next steps were identified to reach the project's targets, including maintaining motivation of community groups, implementing physical modifications in health facilities, and increasing adherence to treatment in MDR patients.