Tuberculosis

A woman is seen to by a team of health workers during the monthly review clinic at Iganga General Hospital MDR-TB Center in East Central Uganda. Photo credit: RHITES-EC

Tuberculosis

Since 1990, URC has worked with 24 of the 30 countries which collectively represent 80% of the global TB burden to combat TB. URC TB programs work with ministries of health, private health providers, and communities to reduce the burden of TB and save lives.

URC TB programs help improve:

  • Case detection, testing, and tracking;
  • Treatment success rates for TB and drug-resistant TB; and
  • Community participation in TB prevention, care, and support.

URC has led programs in more than 24 countries, including 11 World Health Organization high-TB burden countries. From 2016 through 2019, URC-led programs detected nearly 600,000 TB cases, saved nearly 500,000 lives, and reached more than 45 million people through social behavior change communication campaigns and other outreach.

One key tactic is the Finding TB Actively, Separating safely, and Treating effectively (FAST) approach, which includes actively seeking and identifying hospital visitors, patients, and health care workers with TB symptoms, testing them, and educating them about TB. FAST promotes early diagnosis and effective treatment of TB patients as the best two ways to reduce the spread of the disease, especially among health care workers, who are at higher risk of infection. URC is implementing FAST via projects in Uganda, South Africa, the Philippines, and elsewhere.

Strong TB Experience

URC has led TB programs in more than 24 countries, including 11 World Health Organization high-TB burden countries.

URC is helping address TB challenges in a variety of ways to include:

Global Support for TB and MDR-TB – Over the past decade, the global TB CARE II Project has been a USAID lead implementing partner, addressing MDR-TB while working closely with the World Health Organization. The project has implemented more than 36 multi-year activities to control and prevent the spread of TB and MDR-TB. These activities improved treatment outcomes and the quality and breadth of services provided through national TB control programs in more than 15 countries. Activities include efforts to encourage innovation and standardization around implementation approaches to control TB, such as developing tools, guidelines, operating procedures, training manuals, and frameworks.

Digital Health – The USAID TB South Africa Project (TBSAP) created a mobile health application to support TB testing and treatment. The ConnecTB app was used for recording and reporting patient data during directly observed treatment support visits to TB and MDR-TB patients. The app was launched in the Nelson Mandela Bay Metropolitan Health District in June 2015. Within nine months of initiation, loss to follow-up rates in supported areas were much lower than rates in the greater Mandela Bay District area.

A community healthcare worker trained by project partner the Cavite Positive Action Group (CPAG) interacts with a beneficiary. Photo credit: Diwata “Dhee” Paredes

Improving TB Case Notification Rates – The USAID Regional Health Integration to Enhance Services in East Central Uganda (RHITES-EC) Activity supports Uganda’s Ministry of Health to improve regional health outcomes by increasing the use of high-quality health care services. RHITES-EC, which has operated in 12 districts in East Central Uganda since 2016, supports districts and facilities to implement national TB Program strategies, resulting in: an improvement in the TB case notification rate from 92/100,000 at project start to 100/100,000 every quarter beginning in 2018; increased TB treatment success rates from 74% at project start to an average of 80% per quarter; and TB cure rates that increased from 50% to 61% in early 2020.

Community Involvement – The USAID TB Platforms for Sustainable TB Detection, Care and Treatment designed and pretested a social behavior change strategy, called Tibay ng Dibdib – literally, “chest strong,” which aims to improve knowledge and risk perception of TB among Filipinos. Part of the strategy included the creation of a story and coloring book. The books tell the story of two young TB survivors who overcame the disease with support of family and the community. In Marawi, this concept was tested and later scaled up with buy-in from the regional centers for health development.