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

The project focused on several technical areas, including Universal and Early Access, Laboratories, Infection Control, PMDT, and Health Systems Strengthening. The project's overall work plan completion was 30% as of the end of the reporting period. In the Universal and Early Access technical area, significant achievements were made. The Akmola regional training center was established, and a protocol on outpatient care and psychosocial patient support for TB patients in Akmola region was approved by the Akmola Health Department and regional Sanitary-Epidemiological Service. The protocol was developed and approved in February 2013, and implementation of outpatient care and PSS support for TB patients started in January 2013. The first trainings on outpatient care and patient support were conducted in March 2013. In the Laboratories technical area, 1,005 successful tests were performed by three sites in January-March 2013, with an Xpert MTB positivity rate of 43.7% and RIF resistance rate of 48.06%. The revised and updated PMDT protocols were approved by NTP in March 2013 and will be distributed to NTP and project sites in April 2013. The project also made progress in the PMDT technical area. The development of national guidelines on the management of drug-resistant TB was started in March 2013, and a manuscript on psychosocial support improving treatment adherence among MDR-TB patients was published in the Open Infectious Diseases Journal in January 2013. Kazakhstan was selected for piloting the New Funding Model of the Global Fund to Fight AIDS, Tuberculosis and Malaria. The Ministry of Health accepted the invitation and officially sent the agreement to the Global Fund in Geneva. Nine GeneXpert machines are on the way to Kazakhstan, which will be placed in the bacteriological laboratories of the oblast TB dispensaries and will follow the previously developed National Xpert strategy for implementation and use. The project's quarterly activity plan report showed that several activities were completed or in progress, including the establishment of the Akmola regional training center, trainings on outpatient care and patient support, and supportive supervision visits to Akmola oblast. The project also planned to conduct a workshop in Akmola oblast to discuss interim results, train prison staff and NGOs on patient counseling, and support inter-agency coordination body at project level. The project's overall progress was on target with delivering on APA3 work plan activities. The project's cumulative progress and deliverables were up-to-date, with several activities completed or in progress. The project's technical completion was 30% as of the end of the reporting period.