TB CARE II FAST Activity in Malawi

The project focused on adapting the facility-level core package of the FAST strategy, which stands for Finding TB suspect cases Actively through cough surveillance, Separating them until diagnosis, and initiating effective Treatment early. The activity sought to demonstrate the applicability of the FAST package of programmatic interventions at the HIV entry point by refocusing identification of TB cases as an urgent infection control priority for both patients and healthcare workers. The project was implemented in Mangochi and Machinga district hospitals, where TB CARE II trained 118 healthcare workers in Mangochi and 129 in Machinga. The training focused on screening, referring, and diagnosing TB. The project also supplied commodities such as recording/reporting forms and laboratory consumables. Weekly data review meetings were organized to improve the quality of data reported and strengthen implementation. The project achieved significant results, including the identification of 928 presumptive TB cases, with 51 smear-positive results and 64 MTB-positive cases. The proportion of presumptive TB cases among the total number of people screened was 50%, and the proportion of presumptive cases who had smear-positive results was 5%. The project also reported a high proportion of people tested through Gene Xpert who were MTB-positive, at 13%. However, the project faced several challenges, including the lack of written authorization from the NTP to alter the existing Xpert Algorithm and issues with the Xpert machines. Additionally, some staff members were not actively screening as required per FAST protocol. Continuous mentorship and quality control were required to streamline the active screening activities. The project prioritized several activities for the next quarter, including holding weekly FAST review meetings to determine progress and come up with more strategies to overcome challenges. Recommendations from weekly review meetings would be discussed and implemented, and there was a need for uninterrupted supply of reporting and recording tools to the pilot districts. The TB CARE II FAST Activity in Malawi demonstrated the effectiveness of the FAST strategy in improving infection control and rapidly identifying TB patients at HIV service points. The project's achievements and challenges highlighted the importance of continuous mentorship and quality control in streamlining active screening activities. The project's results and lessons learned would be documented and shared widely to inform future scale-up efforts. The project's implementation in Malawi was part of a larger effort to improve TB control and prevention in the country. The TB CARE II program had been working to strengthen TB services in Malawi, and the FAST Activity was a key component of this effort. The project's success would contribute to the overall goal of reducing TB incidence and mortality in Malawi. The TB CARE II FAST Activity in Malawi was a collaborative effort between TB CARE II, the National TB Program, and other stakeholders. The project's implementation was supported by the US Government, and the results would inform future scale-up efforts in Malawi and other countries. The project's achievements and challenges would be documented and shared widely to inform future efforts to improve TB control and prevention in the region.