TB CARE I - Zambia Year 2 Quarterly Report October-December 2012

The overall work plan completion stands at 82%. The report focuses on the achievements in Universal and Early Access, Laboratories, Infection Control, PMDT, TB/HIV, Health Systems Strengthening, and M&E, Operational Research, and Surveillance. In the Universal and Early Access technical area, the Patient Centered Approach (PCA) initiative is being implemented in North Western province in three districts, namely Solwezi, Kabompo, and Mwinilunga. TB CARE I staff members participated in the collection of baseline data in these districts, with two consultant facilitators and 15 research assistants. The initiative has three main phases: baseline survey, implementation of PCA tools, and endline survey. The Laboratories technical area has seen significant progress, with the implementation of the national courier system beginning with a baseline assessment in four selected pilot provinces of Central, Eastern, Copperbelt, and Northern provinces. A team of Ministry of Health and TB CARE I laboratory staff conducted a baseline assessment using three structured questionnaires. Interviews were administered face-to-face to clinical managers of one MDR-TB facility in the Copperbelt province, laboratory staff, other hospital staff members, Provincial Medical Officers, and District Medical Officers. A total of 84 respondents participated in the interviews. In the Infection Control technical area, the Ndola District TB IC demonstration site project received approval for $98,650 in core funding for project continuation for one year from October 2012. Focus activities include the review and inclusion of IC activities in the facility planning cycle of 2013-2014. Other activities that will be implemented include the screening of health care workers for TB and HIV, use of smartphone technology in the FAST strategy, and end-evaluation of project successes. The PMDT technical area has seen significant progress, with TB CARE I KNCV regional consultant Dr. Victor Ombeka providing technical support to the NTP to reconstruct PMDT data at two referral hospitals, using the newly printed MDR-TB reporting and recording tools. The data reconstruction will help the NTP to provide MDR-TB patient data for the country. In the TB/HIV technical area, TB CARE I provided support for 5 DOTS trainings for 122 community volunteers. Training volunteers has proven cardinal as they assist poorly staffed health care workers in identifying TB suspects who are subsequently screened for HIV once TB diagnosis is confirmed. Early diagnosis of both TB and HIV, with prompt treatment, is associated with better outcomes. The Health Systems Strengthening technical area has seen significant progress, with two MoH and four TB CARE I staff members participating in the 43rd World Union conference held in Kuala Lumpur, Malaysia. The team participated in a number of key meetings organized by the Program Management Unit (PMU) during the conference. A poster presentation titled 'Selection of supervising laboratories for peripheral facilities in the EQA program for the Copperbelt Province of Zambia' was also made by Robertson Chibumbya - TB CARE I Technical Officer Laboratory services. The M&E, Operational Research, and Surveillance technical area has seen significant progress, with four draft protocols developed by a team of MoH staff members, research staff from the University of Zambia, and TB CARE I local and international partners. The project plans to finalize the protocols for local ethical approval in the next quarter. The draft protocols are under the following themes: 1. What are the best strategies to promote and scale up integration of screening of HIV and TB amongst household contacts of smear positive TB patients? 2. What factors contribute to long turnaround time for sputum smear microscopy results for TB suspects and follow-up patients? 3. Assessing barriers to timely screening and diagnosis of tuberculosis in prison inmates in Zambia, 4. Study to determine barriers in the Identification and referral of MDR-TB suspects for diagnosis in Zambia. TB CARE I will complete the Year 2 activities during Year 3 of project implementation. The project has not experienced any major challenges this quarter. The NTP continues to receive support from the United Nations Development Fund (UNDP) for implementation of Global Fund activities.