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The USAID-funded Integrated Health Services Activity (IHSA) is a five-year project implemented in Benin.

Access to safe essential medicines is a critical component of an effective health care system. The Ministry of Health (MOH) in Ukraine is directly responsible for the procurement of medicines for several priority health programs, including HIV/AIDS, tuberculosis (TB), and viral hepatitis.

The Systems for Improved Access to Pharmaceuticals and Services (SIAPS) Program worked to ensure the availability of quality pharmaceutical products and effective pharmaceutical services to achieve desired health outcomes.

Please download to read the USAID Safe, Affordable, and Effective Medicines for Ukrainians (SAFEMed) Activity in Ukraine News Digest, September edition.

AbstractThe Philippines is one of the highest tuberculosis (TB) burden countries in the world with nationwide coverage of directly observed treatment, short-course (DOTS) achieved in 2003. This study reports on the National TB Control Programme (NTP) surveillance data for the period 2003 to 2011.

In low income countries, Ziehl-Neelsen sputum smear microscopy is the only cost-effective tool for diagnosis and monitoring of patients on treatment for tuberculosis.The objective of this study was to investigate the role of AFB microscopy refresher training on the performance of laboratory professionals in Ethiopia. Training has improved theoretical and practical performance of laboratory professionals. Pre-placement and continuous training irrespective of lab professionals' qualifications and service year and sustainable external quality assessment are highly recommended to ensure quality of AFB microscopy services.

Equipping medical graduates with the competence to manage tuberculosis is not just imperative, but also urgent as the disease has been consistently listed as one of the major causes of morbidity and mortality in Nigeria. However, there were no baseline studies done on knowledge of final year medical students on various aspects of TB diagnosis and management under directly observed treatment short course therapy (DOTS), which forms the basis of this study. A total of 241 final year medical students from three medical colleges in Nigeria were interviewed. The questions assessed their knowledge about various modes of transmission, symptoms, and management of tuberculosis under DOTS. The study reveals gross inadequacies in TB knowledge and management practices among Nigerian final year medical students. There is urgent need for incorporation of National TB guidelines into existing undergraduate medical education curriculum, as well as student rotations through activities in DOTS clinics.

We set out to evaluate the variation in prevalence of drug resistant tuberculosis (DR-TB) and its determinants across sub-Saharan African (SSA) countries--excluding South Africa--among new and previously treated TB patients. A search of PubMed, EMBASE, Cochrane and bibliographies of DR-TB studies yielded 726 studies published between 2003 and 2013, of which 27 articles fulfilled the inclusion criteria. Studies reported drug susceptibility testing results for a total of 13,465 new and 1,776 previously treated TB patients. The pooled estimate of any DR-TB prevalence among the new cases was 12.6%, while for MDR-TB this was 1.5%. Among previously treated patients, these were 27.2% and 10.3%, respectively. DR-TB (any and MDR-TB) did not vary significantly with respect to study characteristics. The reported prevalence of DR-TB in SSA is low compared to WHO estimates. MDR-TB in this region does not seem to be driven by the high HIV prevalence rates.

Ziehl-Neelsen (ZN) bright-field microscopy is time-consuming, with poor sensitivity, even under optimal conditions. Introduction of Primo Star iLED fluorescent microscopy (FM) may improve TB case finding at referral hospitals in Rwanda. Laboratory technicians demonstrated high acceptance of iLED. The 100% concordance at both demonstration sites during the continuation phase shows technicians' rapid command of the new iLED microscope in a relatively short time. Additionally, fluorescent microscopy reduces the time necessary for examination by more than half. The high level of agreement between iLED and FM during implementation in both sites provides initial evidence for iLED to replace current methods.

In 2011, Ethiopia introduced a strategy of symptomatic tuberculosis (TB) screening for patients attending out-patient services to increase identification of presumptive TB. We assessed implementation and factors affecting symptomatic TB screening in 86 health centres in the Amhara Region. A quarter (28%) of the health centres in this study had poor symptomatic TB screening practices in the out-patient services. Strengthening multidisciplinary teams and expanding partner support are recommended to improve TB screening practices in Ethiopia. 

Twelve Stories of How MSH Is Advancing Health around the World This compendium of stories was submitted through an internal story-telling contest at MSH and represents the lifesaving work MSH and the frontline health workers we partner with perform every day, around the world.

This page provides a technical brief for the QuanTB software.QuanTB is an electronic quantification and early warning system designed to improve procurement processes, ordering, and supply planning for tuberculosis (TB) treatment.

In 2011 the Help Ethiopia Address the Low TB Performance (HEAL TB) Project used WHO or national TB indicators as standards of care (SOC) for baseline assessment, progress monitoring, gap identification, assessment of health workers’ capacity-building needs, and data quality assurance. In this analysis we present results from 10 zones (of 28) in which 1,165 health facilities were supported from 2011 through 2015. The improvement in the median composite score of 13 selected major indicators (out of 22) over four years was significant. The proportion of health facilities with 100% data accuracy for all forms of TB was 55.1% at baseline and reached 96.5%. In terms of program performance, the TB cure rate improved from 71% to 91.1%, while the treatment success rate increased from 88% to 95.3%. In the laboratory area, where there was previously no external quality assurance (EQA) for sputum microscopy, 1,165 health facilities now have quarterly EQA, and 96.1% of the facilities achieved a ≥ 95% concordance rate in blinded rechecking. The SOC approach for supervision was effective for measuring progress, enhancing quality of services, identifying capacity needs, and serving as a mentorship and an operational research tool.

This study compared the yield of TB among contacts of multidrug-resistant tuberculosis (MDR-TB) index cases with that of drug-sensitive TB (DS-TB) index cases in a program setting. The yield of TB among contacts of MDR-TB and DS-TB using GeneXpert was high as compared to population-level prevalence. The likelihood of diagnosing RR (Rifampicin Resistant)-TB among contacts of MDR-TB index cases is higher in comparison with contacts of DS-TB index cases. The use of GeneXpert in DS TB contact investigation has an added advantage of diagnosing RR cases in contrast to using the nationally recommended AFB microscopy for DS TB contact investigation.

This study in the Amhara and Oromia regions of Ethiopia assessed the outcomes of tuberculosis (TB) treatment among children younger than 15 years. Retrospective data were collected on treatment outcomes and their determinants for children with TB for the cohorts of 2012-2014 enrolled in 40 hospitals and 137 health centers. Chi-square tests, t-tests, and logistic regression were used for the analysis. Of 2,557 children registered, 1,218 (47.6%) had clinically diagnosed pulmonary TB, 1,100 (43%) had extrapulmonary TB, and 277 (8.9%) had bacteriologically confirmed TB. Among all cases, 2,503 (97.9%) were newly diagnosed and 178 (7%) were HIV positive. Two-thirds of the children received directly observed treatment (DOT) in health centers and the remaining one-third, in hospitals. The treatment success rate (TSR) was 92.2%, and the death rate was 2.8%. The childhood TSR was high compared with those reported in focal studies in Ethiopia, but no national TSR report for children exists for comparison. Multivariate analysis showed that being older-5-9 years and 10-14 years-enrolled in DOT in a health center, and HIV negative were predictors of treatment success, whereas underdosing during the intensive phase of treatment was negatively correlated with treatment success. We recommend more research to determine if intensive monitoring of children with TB, dosage adjustment of anti-TB drugs based on weight changes, and training of health workers on dosage adjustment might improve treatment outcomes.

The three-year Care and Treatment for Sustained Support (CaTSS) project was implemented by MSH in close partnership with the Government of Nigeria and local partners.

Tuberculosis (TB) is geographically heterogeneous, and geographic targeting can improve the impact of TB interventions. However, standard TB notification data may not sufficiently capture this heterogeneity. Better understanding of patient reporting patterns (discrepancies between residence and place of presentation) may improve our ability to use notifications to appropriately target interventions. Using demographic data and TB reports from Dhaka North City Corporation and Dhaka South City Corporation, we identified wards of high TB incidence and developed a TB transmission model. We calibrated the model to patient-level data from selected wards under four different reporting pattern assumptions and estimated the relative impact of targeted versus untargeted active case finding. Movement of individuals seeking TB diagnoses may substantially affect ward-level TB transmission. Better understanding of patient reporting patterns can improve estimates of the impact of targeted interventions in reducing TB incidence. Incorporating high-quality patient-level data is critical to optimizing TB interventions.

Despite a steadily declining tuberculosis (TB) rate, averaging 8% per year, Ethiopia continues to be a high-TB-burden country. By building upon previous TB control efforts, the five-year USAID Eliminate TB Project will accelerate and sustain TB elimination efforts in Ethiopia to meet the End TB targets by 2035.

The five-year USAID Eliminate TB Project builds on MSH’s contributions to Ethiopia’s TB control efforts for the past 15 years.

Please download to read the USAID Safe, Affordable, and Effective Medicines for Ukrainians (SAFEMed) Activity in Ukraine News Digest, January 2020 edition.

Please download to read the USAID Safe, Affordable, and Effective Medicines for Ukrainians (SAFEMed) Activity in Ukraine News Digest, November 2019 edition. 

Many women in low and middle-income countries face gaps in access to high-quality ANC: they often do not receive the recommended services for a healthy pregnancy, experience poor quality of care, and are treated disrespectfully. In Kenya, most women attend at least one ANC visit (97%), and 60% of women complete the recommended four or more visits.

High-quality, patient-centered antenatal care (ANC) is a key strategy for improving maternal and newborn health and a critical component in the continuum of care.

The Prevention and Organizational Systems – AIDS Care and Treatment Project (PRO-ACT), a part of the President’s Emergency Plan for AIDS Relief (PEPFAR), was implemented in Nigeria from July 16, 2009 through November 14, 2016.

Adequate infrastructure plays a critical role in the delivery of quality health care as it ensures appropriate space and an environment for dignified and respectable care while supporting the implementation of infection prevention measures.In May 2017, ONSE conducted a Health Facility Assessment of 424 public and private-for-profit health facilities in the 16 supported districts, identifying cruci