TB CARE I - Botswana Year 3 Quarterly Report January-March 2013

The report indicates that the overall work plan implementation is at 50% according to schedule. TB CARE I collaborated with the Centers for Disease Control and Prevention (CDC) to support GeneXpert training for 5 laboratory technicians, including 2 females, at two GeneXpert rollout sites. The in-country Senior Technical Advisor, Dr. Diriba Agegnehu, facilitated two rounds of combined training for community TB care, household TB infection control, and revised indicators for the Global Fund/Transitional Funding Mechanism (GF/TFM). A total of 85 participants, including 50 females, from GF/TFM sub-recipients were trained. TB CARE I also provided technical support for the planning and implementation of the first bi-annual MDR clinical meeting in Maun, Botswana. The meeting was attended by high-level government officials and partners. Additionally, TB CARE I supported the coordination and planning of World TB Day activities, which included the launch of the TB CARE I-supported National Strategic Plan by the Vice President of Botswana. The report highlights several challenges faced by the National Tuberculosis Reference Laboratory (NTRL), including shortages of supplies, which have forced the laboratory to revert to using LJ media. However, the CDC and Supply Chain Management system have provided funds to procure reagents in the interim. Discussions with the NTP are ongoing to engage the Deputy Permanent Secretary to follow up on the NTRL being given status to handle its own budget for procuring supplies. The Transitional Funding Mechanism has successfully passed the grant negotiation phase with TB CARE I support. Feedback regarding key issues raised by the grant manager is being sent by the NTP, and the agreement has been signed. It is expected that disbursement for the grant will be according to schedule. TB CARE I laboratory specialist, Mr. Obert Kachuwaire, provided technical input into LED Fluorescent smear microscopy, supporting the training of 18 laboratory technicians, including 6 females, over three workshops. The National TB Reference Laboratory maintained SANAS Accreditation through technical input into accreditation. The report also highlights the roll-out of GeneXpert to 20 facilities, with TB CARE I supporting the roll-out to 5 sites. The activity is still on track to achieving Xpert roll-out in a total of 20 facilities by the end of APA 3. The validation of new diagnostics, including Liquid DST and LPA, is being finalized, with initial phase of testing at NTRL complete and preliminary reports produced. The quarterly MDR-TB report indicates that 19 MDR TB cases were diagnosed and 14 were put on treatment in the country during the January-March 2013 period. The report also highlights the completion of several international visits, including a backstopping visit by Jerod Scholten and a technical assistance visit by Valentina Anisimova. Overall, the report highlights significant achievements in TB control efforts in Botswana, including the successful roll-out of GeneXpert and the training of laboratory technicians. However, challenges faced by the NTRL, including shortages of supplies, are also highlighted.