Quarterly Report: USAID TB CARE II South Africa Project, April – June 2015

This strategy aims to screen 90% of vulnerable communities, initiate 90% of presumptive TB clients on treatment, and cure 90% of TB patients. The Deputy President of South Africa, Mr. Cyril Ramaphosa, launched the "Massive TB Screening Campaign" on World TB Day, March 24, 2015, as the key strategy for achieving these ambitious targets. The project has implemented several activities in the third quarter of FY15, including the use of mobile health (mHealth) technology in the Nelson Mandela Bay Metro (NMBM). This technology enables Directly Observed Treatment (DOT) providers to input patient information on a smartphone, which is then reviewed in real-time, allowing for quick advice on side effects and patient retention. The mHealth technology has yielded replicable results in patient retention and remote supervision of DOT providers. The project has also implemented online training for physicians and healthcare workers on the management of TB in the pediatric population. This training is accredited by the Health Professionals Council of South Africa (HPCSA) and the Independent Practitioners Association Foundation (IPAF), allowing for flexible uptake of critical knowledge and continuous assessment of knowledge retention. In addition, the project has established strategic partnerships with the South African Business Coalition on Health and AIDS (SABCOHA) to increase the reach of TB interventions. The project organizes trainings of peer educators in the workplace, which remains the largest captive audience for health interventions. These trainings aim to increase awareness and knowledge of TB among employees, ultimately reducing the spread of the disease. The project has also made progress in improving the management of TB and drug-resistant TB (DR-TB) in children. The Desmond Tutu Tuberculosis Centre (DTTC) has been involved in the development of guidelines for the management of TB in children, and the project has provided training to healthcare workers on the use of these guidelines. Furthermore, the project has implemented a data enhancement exercise to improve the management of DR-TB. This exercise aims to enhance the quality of data on DR-TB cases, which will inform the development of effective treatment strategies and improve patient outcomes. The project has also made progress in improving the management of TB support systems. The Electronic Tuberculosis Register (ETR) has been implemented in several districts, which has improved the tracking and management of TB cases. The project has also conducted data verification exercises to ensure the accuracy of TB data. In terms of monitoring and evaluation, the project has established several performance management indicators, including TB case finding, bacteriological coverage, smear conversion rates, treatment success and cure rates, and TB-HIV integration. The project has also conducted a midterm evaluation, which revealed a 27% increase in household income among program participants compared to the control group. The project has also implemented several activities for the next quarter, including the expansion of the mHealth technology to other districts, the development of guidelines for the management of TB in children, and the implementation of a public-private partnership to increase the reach of TB interventions.