Quarterly Report: USAID TB CARE II Project South Africa, October – December 2015

The project focused on technical areas including improved quality of TB services, increased availability of TB treatment, increased demand for TB services, improved management of TB support systems, and new approaches for expanding Directly Observed Treatment, Short Course (DOTS) coverage. The project provided support to the Drug Resistant TB (DR TB) review committees to monitor and ensure treatment initiation of all DR TB patients. Decentralized care of DR TB clients, with a focus on treatment initiation at decentralized sites, has been instrumental in reducing high mortality rates and improving treatment initiation rates. In the Eastern Cape, 96% of confirmed DR TB patients were initiated on treatment, while in KwaZulu-Natal, 89% were initiated, and in the Western Cape, 100% were initiated. TB case notification for the project-supported districts was 29,807. The bacteriologic coverage was 81.4% in the supported districts, with significant improvements noted in Free State. The treatment success rate (TSR) was 80% for the supported districts, with five districts meeting the target and 16 reporting TSR of greater than 80% for new smear-positive cases. Reports generated in supported district databases demonstrated a steady increase in TB clients receiving HIV services. The co-trimoxazole uptake rate increased from 86.6% in the previous quarter to 91% in the reporting quarter, and ART improved from 75.7% to 82%. Overall, HIV testing in TB patients was at 94%. In Cape Winelands district, Western Cape, a folder review was conducted, which reported 19% of TB cases being children. The USAID TB CARE II South Africa Project, in collaboration with the Western Cape Department of Health, developed a concept document on case detection of index TB cases. Continued screening of TB amongst children showed a 24% increase of TB cases among children from October to December 2015. The project, in partnership with the KwaZulu-Natal Department of Health, Department of Social Development, and Department of Education, launched a partnership to tackle TB in schools, particularly in Early Childhood Development Centres (ECDCs). The partnership reached over 3,500 people, including children and their caregivers, with 500 children screened for TB. The project supported 9 facilities in UThungulu and Ugu Districts in KwaZulu-Natal and Sedibeng district in Gauteng province to strengthen TB and Diabetes Mellitus (DM) screening in facilities. Two hundred and twenty-three health care workers were trained on integration of services. During the reporting period, a total of 1,496 patients with diabetes were screened for TB, and two patients were diagnosed with TB. The project's efforts to improve TB services and treatment outcomes have been successful, with significant improvements noted in bacteriologic coverage, treatment success rates, and HIV testing in TB patients. The project's partnerships with government departments and other stakeholders have also been instrumental in tackling TB in schools and strengthening TB and DM screening in facilities.