Quarterly Report: TB CARE I - Ghana Year 4 January-March, 2014

The project's lead partner is MSH, and its work plan timeframe is from October 1, 2013, to September 30, 2014. The project's quarterly report for January-March 2014 highlights several significant achievements. One of the key achievements is the review of hospital TB case detection performance in 2013. TB CARE I is supporting the implementation of intensified hospital-based TB case detection at six hospitals in three districts of Ghana's Eastern Region. In 2013, these hospitals detected 569 TB cases, achieving 96 percent of their target. The hospitals also reported a 10 percent increase in TB cases detected in 2013 compared to 2012 and a 54 percent increase compared to 2011. The project also supported two regional annual review meetings in the Western and Eastern Regions. In the Western Region, the meeting focused on assessing TB data quality in 23 districts, and in the Eastern Region, the focus was on improving community involvement in TB care. The project team found that community health officers do not yet have the capacity to effectively contribute to community-based TB control services. Another significant achievement is the development of a short training guide on quality clinical care for TB patients to address the high rate of TB mortality. Dr. Pedro Suarez, MSH's Global Technical Lead for TB, conducted a short-term technical assistance visit to support the project team in developing this guide. The guide is designed to build the capacity of clinicians to provide quality care for TB patients, and the project team will use it to conduct a training of trainers program for clinicians from the regions and hospitals that consistently report a high rate of TB deaths. The project also supported technical supervision in the Eastern Region, where the monitoring team found that community does not believe in modern medicines, and some villagers showed clear signs and symptoms of TB infection but refused to seek medical care. The monitoring team recommended that the NTP and its partners develop a targeted community sensitization campaign to mitigate the impact of these misconceptions and beliefs about TB. Furthermore, the project updated the joint national TB-HIV policy guidelines, which are currently being reviewed by the TB-HIV Technical Working Group members. The Global Fund's Country Coordinating Mechanism (CCM) has agreed to allow the NTP and the National AIDS Control Program (NACP) to submit a joint concept note to the Global Fund, and both programs will develop and update their national strategic plans (NSP) and develop joint TB-HIV policy guidelines. Technical and administrative challenges faced by the project include diagnosing TB in children, which remains a challenge, and incomplete and inaccurate data in some regions and districts due to high staff attrition. The NTP should prioritize pediatric TB screening and diagnosis, especially since some primary school teachers have been diagnosed with TB and now pose a risk of transmitting the disease to their pupils.