Strengthening Tuberculosis Control in Ukraine: Year 3 – Quarter 3

The project, implemented by Chemonics International in partnership with Project HOPE and the New Jersey Medical School Global Tuberculosis Institute, seeks to improve the quality and expand availability of directly observed treatment, short-course (DOTS)-based TB services. Key accomplishments in the second quarter of Year 3 include the approval of National Guidelines on Cough Management and guidelines on TB/HIV-associated miliary and extrapulmonary tuberculosis by the Ministry of Health. Thirty-nine primary healthcare doctors from new regions completed specialized short-term courses on TB control at the National Medical Academy of Post-Graduate Education. Two hundred participants, including 21 nurses, received training on TB, multi-drug resistant TB, and TB/HIV case management, laboratory tests for TB, and TB infection control through 11 STbCU-supported trainings. The project also supported seminars on detecting patients with suspected tuberculosis and treatment of TB patients according to the revised unified clinical protocol, attracting 180 heads of primary healthcare facilities in Lviv, Kirovohrad, and Odesa oblasts. Additionally, 1,512 healthcare workers from central raion inpatient, outpatient facilities, and primary healthcare points in rural areas received on-the-job technical assistance related to TB diagnostics, treatment, and case management, TB IC practices, and the coordination of TB/HIV services during 85 mentoring visits by multidisciplinary teams. The project also developed a prototype for a future online Training, Information, and Resource Center on TB (TIRC) in collaboration with Otakoi IT-Company and the Ukrainian Center for Socially Dangerous Diseases Control. The website functionality is expected to be developed by the end of the next quarter. The Website Governance Board approved the site for continued development, and resource documents are temporarily housed on the STbCU website. Overall traffic to the project's website, which contains TIRC content, increased to 3,100 unique visitors in April and decreased to 2,700 visitors in June. In terms of laboratory support, 14 Level 1 laboratories in Kirovohrad, Kherson, Lviv, and Zaporizhzhia oblasts received technical support from the project. The project also conducted regional conferences in Kherson, Kharkiv, Odesa, and Lviv to discuss sputum smear microscopy EQA results in 2014 and to plan activities for 2015. The project also made progress in creating a safer medical environment at the national level and in USAID-supported areas. The STbCU revised methodological recommendations on UV radiation, which are in the process of being approved by the Ministry of Healthcare of Ukraine. The methodological recommendations on UV radiation will be the first normative document regulating the work of UV radiation in Ukraine. The project also assisted in the installation and mentoring of proper use of UV radiometers in Ukrainian TB facilities and hospitals. Twenty laboratory specialists at TB facilities received on-the-job-training on infection control provided by the project's IC specialist during 5 mentoring visits. Standard operating procedures were developed and implemented in most of the laboratories, which significantly improves the quality of their work. The project also built capacity to implement programmatic management of drug-resistant TB (PMDT) for MDR and extensively drug-resistant (XDR) TB at the national level and in USAID-supported areas. The Dnipropetrovsk Center of Excellence (CoE) opened an anti-retroviral therapy (ART) site, and one doctor and nurse on staff were trained on the basics of ART administration. To improve infection control, the facility installed 30 combined UV lamps in the high-risk zones and improved the electronic table to record the results of UV lamp output measurement. The project also supported the piloting of the outpatient model of care in Kryvyi Rih, resolving the key issue of the piloting. The pilot in Kriviy Rih city will start on July 1. The project also provided social support programs to TB patients, including patronage services, counseling services, and distribution of patients' diaries. Among 78 patients who completed their treatment, 90 percent completed effectively, confirming the effectiveness of social support programs provided by URSC.