TB CARE I - Nigeria (OP) Year 3 Quarterly Report April - June 2013

The overall work plan completion during the quarter was 47%, with major activities dependent on procurement and delivery of supplies, including Gene Xpert machines, cartridges, and Second Line drugs. TB CARE I provided national and international technical support in the mid-term evaluation of the Nigerian TB strategic plan, covering thematic areas such as PMDT, LAB, Human Resource Development, and M&E. The evaluation identified issues including low case detection, inadequate microscopic coverage, weak childhood TB case management, low ART uptake among co-infected TB patients, and weak PMDT. The final report was made available and utilized in APA 4 planning. A total of 1946 sputa were tested by Gene Xpert, with 2.9% (57) indeterminate results. Further analysis of the data by risk groups indicates that 83% (1614) of those tested were DR TB suspects, irrespective of HIV status. Smear-negative PLHIV constituted 14.1% (272) of total sputa tested, and other AFB smear-negative cases were 57. Of those total sputa tested, about 207 (M=131; F=76) were MTB with RIF resistance. Patients' support was also provided for 50 MDR TB patients enrolled during the quarter. The TB CARE I consortium partners, including KNCV, FHI360, MSH, and WHO, collaborated to achieve the work plan objectives. Key activities included information dissemination, training facility staff on PCA, technical assistance support, and advocacy for sustainable financing. The stakeholder meeting for the control of Childhood TB in Nigeria was held from May 28-31, 2013, in Enugu, with participants from academia, FMoH, NACA, GLRA, and WHO. The quarterly activity plan report highlights the progress and deliverables of various activities, including information dissemination, training facility staff on PCA, technical assistance support, and advocacy for sustainable financing. The overall completion of the work plan was 47%, with major activities dependent on procurement and delivery of supplies. TB CARE I also facilitated the engagement of the Nigerian prison health services in strengthening TB screening among inmates by developing a draft health screening tool. The program also established PPM DOTS (60) centers in 6 states in collaboration with the NTP, with a 50% achievement in establishment. The overall work plan implementation during the quarter was 47%, which is a significant achievement. However, major challenges remain, including the delay in the procurement system and security issues in many of the states.