USAID Defeat TB Project

The USAID Defeat TB project is a 5-Year technical assistance mechanism whose goal is to increase TB case detection, notification and treatment outcomes through health system strengthening with the aim of ending the TB epidemic in Uganda. The project’s objectives include the following:

  1. To increase screening and detection of all forms of TB in infants, children, adolescents, and adults at facility and community levels
  2. To initiate and complete treatment for all TB patients
  3. To ensure strong community systems to support the continuum of TB prevention, screening, diagnosis, care, and treatment
  4. To enhance leadership and technical capacity of the TB program at national and subnational levels

What USAID Defeat TB is doing, Community TB interventions

The USAID Defeat TB project directly implements interventions to end TB in the focus urban districts of Kampala, Wakiso and Mukono. In an effort to establish community structures to increase TB case finding, treatment and prevention, Defeat TB has engaged 14 civil society organisations distributed in high TB burden settings across the three focus districts.

The CSOs conduct the following critical activities

  • community education and mobilization activities for populations to take up TB services
  • Targeted TB screening activities in TB Hotspots and for populations at increased risk for TB
  • Conduct TB contact tracing activities
  • TB treatment education, adherence support and tracking of interrupters
  • Tracking linkages and referrals between community-facility and private-public facilities

During the first 3 months of implementation, The CSOs have found 141 additional TB cases through targeted screening of 11,000 people including contacts of TB patients, populations living in slums, prisons, refugees, fisher-folk and contacts in schools.

CSOs Provided DOT to XX TB patients

Traced XX patients that interrupted TB treatment and returned them to care

Uganda TB Burden and key statistics

Tuberculosis (TB) is an infectious airborne disease caused by a germ and is transmitted through air from a TB patient mainly through coughing, talking, singing, sneezing without covering the nose and mouth. Several people with TB do not know that they have the disease.

According to the National TB prevalence survey, about 80,000 Ugandans develop Tuberculosis every year and yet 4 out of every 10 affected persons are not diagnosed; they stay within the community and continue to spread disease. Every untreated TB patient spread disease to about 15 other people every year.

Common Symptoms of TB

 

One could have TB if they have any of the following symptoms

  • cough for 2 or more weeks; sometimes with sputum which can be blood stained
    • Fevers especially in the evening
    • Sweating, especially at night
    • Unexplained weight loss
    • Poor weight gain for children
    • History of being in contact with a TB patient for children under 5 years
    • Chest pain
    • Sometimes lumps (swollen lymph nodes) in the neck or armpits
    • TB can affect different parts of the body and may be difficult to detect if a person does not seek the services of a qualified health worker

Testing for TB

  • Anyone with any of the above symptoms is advised to visit the nearest health facility for assessment to determine whether they have TB and to receive TB treatment if required. He or she will be interviewed, examined and may be requested to provide a sputum sample for examination and or have an X-ray taken in addition to other tests that may be required

TB is curable

  • Drug sensitive TB (responds to the first line of treatment); is curable if treated for 6 months
  • Drug resistant TB (Does not respond to the key drugs in the first line of treatment) is curable if consistently treated for 9-24 months

TB is preventable if all TB patients

  • complete treatment and get cured
  • Stay outdoors most of the day and open windows for aeration when inside the house
  • Bring all contacts at home and work for assessment and early initiation treatment when required
  • Bring children under 5 years for TB preventive treatment

The community is educated and empowered to identify TB symptoms and support patients to seek and complete treatment

Challenges to Ending TB in Uganda

  • 80,000 Ugandans are estimated to develop TB annually
  • About 40% (32,000 people with TB are missed annually) and remain in the community posing increased risk for TB spread
  • About 40% of TB patients are co infected with HIV and this increases the risk of death unless they are detected and treated early
  • About 10% of patients with drug sensitive TB die and about 15% (about 7,000 patients) abandon treatment and remain in the community
  • About 14% of patients with drug resistant TB die while another 14% abandon treatment and remain in the community
  • The health care workers are few and fully engaged in providing curative services for patients that reach the health facilities

In order to find the missed TB cases, link them to treatment and treat them to cure, there is need for greater community engagement and interventions

What USAID Defeat TB is doing, Community TB interventions

The USAID Defeat TB project is a 5-Year technical assistance mechanism whose goal is to increase TB case detection, notification and treatment outcomes through health system strengthening with the aim of ending the TB epidemic in Uganda. The project’s objectives include the following:

  1. To increase screening and detection of all forms of TB in infants, children, adolescents, and adults at facility and community levels
  2. To initiate and complete treatment for all TB patients
  3. To ensure strong community systems to support the continuum of TB prevention, screening, diagnosis, care, and treatment
  4. To enhance leadership and technical capacity of the TB program at national and subnational levels

The USAID Defeat TB project directly implements interventions to end TB in the focus urban districts of Kampala, Wakiso and Mukono. In an effort to establish community structures to increase TB case finding, treatment and prevention, Defeat TB has engaged 14 civil society organisations distributed in high TB burden settings across the three focus districts.

The CSOs conduct the following critical activities

  • community education and mobilization activities for populations to take up TB services
  • Targeted TB screening activities in TB Hotspots and for populations at increased risk for TB
  • Conduct TB contact tracing activities
  • TB treatment education, adherence support and tracking of interrupters
  • Tracking linkages and referrals between community-facility and private-public facilities

During the first 3 months of implementation, The CSOs have found 141 additional TB cases through targeted screening of 11,000 people including contacts of TB patients, populations living in slums, prisons,refugees, fisherfolk and contacts in schools.

CSOs Provided DOT to XX TB patients

Traced XX patients that interrupted TB treatment and returned them to care

What key message do we want to communicate through the media?

  • It will be impossible to end TB without investing in activities to increase community engagement;
  • TB patients are infected from the community and they seek care at the health facilities and return to the community where some abandon treatment before completion.
  • Every TB patient has a source of disease from within the community. Therefore, the community ‘which starts with you’ listening/watching this can actively participate in finding TB patients by identifying persons with symptoms listed and taking them to the nearest health facility for assessment, testing and treatment.
  • TB patients on treatment need support to stay on and complete treatment prescribed (they should not stop treatment even when they feel better because they risk developing worse forms of disease or even die)
  • To end TB in Uganda, at least 90% of the estimated TB patients in the community need to be identified through screening of individuals at risk for TB; at least 90% need to be started on TB treatment; at least 90% need to complete treatment and 90% of eligible individuals should start and complete TB preventive treatment.
  • Defeat TB has demonstrated success in achieving TB results through engagement of community structures; CSOs in this case. There are alternative structures that can perform similar function once adequately resourced
  • Call to action for Ministry of Health, Funders, IPs, District health teams and communities to prioritize and allocate resources for effective engagement of the community to end TB in Uganda.
  • ‘It is time to end TB in Uganda, it starts with you”