TB CARE I - Mozambique Year 3 Quarterly Report October-December 2012

The report highlights the progress made in various technical areas, including Universal and Early Access, Laboratories, Infection Control, PMDT, TB/HIV, Health Systems Strengthening, and Drug Management. In the Universal and Early Access technical area, 6,670 TB suspects and 3,690 malaria suspects were referred to health facilities during the quarter. A total of 1,214 TB cases were diagnosed, with 807 (66.5%) diagnosed as SS+, 332 (27.3%) as SS-, and 75 (6.2%) as having TB EP. Out of the total number of malaria suspects referred by community volunteers, 3,184 tested positive to malaria. The Laboratories technical area focused on the introduction of GeneXpert technology. A total of 82 clinical staff from three sites were trained in the introduction of GeneXpert technology, the algorithm to be used, and sample referral from remote areas to the testing sites. An additional 15 LED microscopes were procured and distributed to 15 selected sites, and 37 laboratory technicians will be trained from these sites in March 2013. To improve the quality of AFB smear microscopy using Ziehl-Neelsen, 400 job aids were printed and distributed all over the country. In the Infection Control technical area, TB CARE I supported the conduction of an IC training targeting national and provincial infrastructure technicians from all the provinces on infection control and adequacy of construction and rehabilitation of health facilities projects. This training was the first in the country and introduced construction technicians to TB infection control concepts. The PMDT technical area focused on the development and finalization of the PMDT national expansion plan. TB CARE I led and supported the process, and several technical working group meetings were held. The draft plan was approved to guide case management of MDR TB patients in the following months and establish steps to expand levels of assistance. The TB/HIV technical area involved the training of MOH clinicians and other FHI360 projects in Niassa, Sofala, Manica, and Tete provinces. The training aimed to increase TB/HIV activities and collaboration between projects and MOH. In the Health Systems Strengthening technical area, the TB CARE I project supported the participation of five people in the 43rd Kuala Lumpur UNION Conference held from November 12 to 18, 2012. A total of five presentations were made, and this was an opportunity for team members to share lessons learned in TB, TB/HIV, and other lung-related diseases with the rest of the world. The Drug Management technical area focused on distribution. From the 203 items requested, 80% (162) were issued, compared to 92% in the previous quarter. The total quantities for those with stock on hand were maintained (average = 92%, comparing to 91% in the previous quarter). All SLDs were available and supplied. The report also highlights the progress made in the Malaria technical area, including the training of 8 laboratory technicians in laboratory certification through exchange visits conducted with the Manhiça Health Research Centre. Two vehicles were acquired through the PMI funding mechanism to support the NMCP in Malaria supervision activities. The TB CARE I project also provided partial support in the successful commemorations of the SADC Malaria day celebrations held in Manhica district of Mozambique on November 9, 2012. The report concludes that implementation is at 11% for this reporting quarter, with activities implemented being only APA2 carry-over activities considered approved for APA3. The overall APA3 budget and workplan had not been approved by then, resulting in a late start to APA3 implementation. The Global Fund (GF) has disbursed funds for the purchase of first and second-line drugs, and the team is finalizing minor adjustments on the transitional funds mechanism proposal approved.