Quarterly Report: TB CARE I - Zambia (3 I's) Year 5, January - March 2015

The project's work plan timeframe is from October 2014 to July 2015, with the reporting period being January to March 2015. Intensified Case Finding (ICF) was a significant achievement during this quarter. TB CARE I provided ICF support in the Central and Copperbelt provinces, expanding the support to a prison in Ndola district called Kansenji prison. A total of 4,505 individuals were screened with GeneXpert from 18 facilities implementing ICF, out of which 533 were Xpert MTB positive (11.8%). Rifampicin resistance was detected in 20 samples that were referred to the Chest Diseases Laboratory for culture and drug susceptibility testing. Onsite Xpert mentorship and supervisory visits were conducted by representatives from the Ministry of Health, Ministry of Community Development Mother and Child, and TB CARE I. The visits provided an assessment of the staff skills and knowledge on Xpert implementation in all the sites. Onsite mentorship in GeneXpert for the National Tuberculosis Reference Laboratory (NTRL) staff members was also done this quarter by the TB CARE I Senior Technical Officer for Laboratory Services. TB CARE I participated in the national and district level commemorations of the World TB Day this year. The national commemoration was held in Mongu, Western province on March 24, 2015. Facility level activities were held in the Central and Copperbelt provinces, including sensitization of schools and vendors in the market place in Chisamba district, drama performances in Kapri Mposhi, and door-to-door sensitization in Chimwemwe clinic catchment area of Kitwe district. TB Infection Control support to prisons was also provided during this quarter. A TB IC risk assessment visit was conducted from February 16-17, 2015, and TB IC training was conducted from March 17-18, 2015. A total of 25 staff members were trained, with representatives from Central and Copperbelt provinces. District level project close-out meetings were held by TB CARE I in all the participating districts from February 9-13, 2015. Recommendations were made to the project that will be provided as part of the final project report. A national level close-out meeting has been planned for May 14, 2015. Preparation of manuscripts and evaluation protocol was also a significant activity during this quarter. A workshop was held from March 30 to April 4, 2015, to draft five manuscripts. Participants included six TB CARE I technical staff members, the FHI360 HQ Technical Advisor, the FHI360 Senior Advisor, Research, representatives from the MoH, MCDMCH, and WHO. The project plans to submit the manuscripts for publication to highlight the successes of the work done in Zambia in TB control. The project has made significant progress in achieving its technical outcomes and activity progress. The number of facilities where quality of services is measured has increased to 18, and the number of prisoners diagnosed with TB has increased to 17. The project has also strengthened community intensified case finding in the community, with 124 community volunteers supporting CB-DOTS implementation in the Central and Copperbelt provinces. TB CARE I has procured a total of 12 Xpert machines for project implementation, with three GeneXpert machines being installed in health facilities and prison facilities. The project has also provided support for transport reimbursement to 124 community volunteers this quarter.