TB CARE I - Kyrgyzstan Year 3 Quarterly Report

The project focuses on several technical areas, including universal and early access, laboratories, infection control, and health systems strengthening. In the third year of the project, significant progress was made in the development of a joint plan for TB control in prisons and general TB services. The plan was reviewed by the Prison Service and submitted to the Ministry of Health (MoH) for approval. Additionally, advances were made in the introduction of a new outpatient care model in urban settings, with a draft model developed by the technical working group on outpatient care. In the laboratories technical area, TB CARE I organized a four-day training of trainers (ToT) on GeneXpert for 20 clinical and 10 laboratory specialists. The training covered current international developments, WHO recommendations and guidelines, national GeneXpert strategy, programmatic aspects of GeneXpert implementation, diagnostic algorithms, and clinical protocol. The laboratory specialists ToT included practical laboratory training on how to use, maintain, and troubleshoot GeneXpert machines. The GeneXpert national strategy, including the diagnostic algorithm, was finalized and submitted to the National Tuberculosis Program (NTP) for approval. The document was also sent to the World Health Organization (WHO) and the State National Reference Laboratory (SNRL) for review and endorsement. TB CARE I continued its work on laboratory maintenance guidelines, developing several SOPs with the support of the NRL, which were shared with regional laboratories around the country for piloting. In the infection control technical area, guidelines on TB infection control were approved by the MoH. Printing and distribution of the guidelines will be done with the support of the United Nations Development Programme (UNDP)/Global Fund. TB CARE I also updated and introduced TB infection control plans in seven TB facilities, with the support of the Regional Infection Control Officer. The project also made progress in the health systems strengthening technical area, with three specialists trained in an international course on MDR TB in Riga, Latvia, in October 2012. TB CARE I underwent a USAID financial audit from Washington on December 5-6, 2012, with positive results. In the quarterly activity plan report, several activities were completed or made significant progress. These included the development of a joint plan for TB control in prisons and general TB services, the introduction of a new outpatient care model in urban settings, and the training of national Xpert specialists. Additionally, the laboratory plan was updated, including the activity plan and budget, and the finalization of the laboratory maintenance guideline was completed. The project also faced some challenges, including the development of the protocol on outpatient care, which took longer than expected. The protocol has to match key guideline provisions, and after finalization and approval by the MoH, the new guidelines will serve as a blueprint for the detailed protocol. In-country Global Fund status and update, the second phase of the GF proposal was approved, but not yet started, and the first year of implementation was extended until March. UNDP/GF funds have been reprogrammed for an additional 300 MDR patients, on top of the 500 that were already planned for.