authors: g. qader , m. abdul hafiz , p.g. suarez identifying the … · 2013-01-15 · identifying...

Identifying the Impact of Standard Operation Procedure Implementation on Early TB ���Case Detection in Afghanistan, 2008-2011

Authors: G. Qader1, M. Abdul Hafiz2, P.G. Suarez3, ���M. Seddiq4, S.D. Mahmoodi5 Affiliations: 1Senior Technical Advisor, TB CARE I, Afghanistan; ���2Country Project Director, TB CARE I/Management Sciences for Health (MSH), Afghanistan; 3Global TB Technical Lead, Center for Health ���Services/MSH, Arlington, USA;4Manager, National TB Program of the Ministry of Public Health, Afghanistan; 5General Head of M&E ���Surveillance and Research, National TB Program, Afghanistan

TB Service Needs in Afghanistan §  Afghanistan’s tuberculosis (TB) treatment standard operating

procedures (SOPs) had not been revised since 2004. Health facility staff were not trained in TB service delivery. This caused delayed TB case detection, diagnosis, and treatment.

TB CARE I Responds (2010 – 2012) §  TB CARE I, a USAID-funded project, helped the National ���

TB Program (NTP) revise and print SOPs for TB case detection.

§  TB CARE I and NTP then distributed the following materials to 1,500 clinics: v The revised TB care SOPs and guidelines

v Diagnostic materials

v TB treatment packages

§  TB CARE I and NTP also trained 2,072 health facility staff to use these new tools and materials.

For more information, please contact: G. Qader MD, DPH, MPH, Senior Technical Advisor, TB CARE I, Afghanistan; Tel: +93 797 261 407; Email: gqader@msh.org

Acknowledgement The Government of the United States of America through the US Agency for International Development (USAID) for funding the TB CARE I project.

Assessing SOP Impact (2012) §  TB CARE I and NTP conducted an assessment to determine

the impact of SOP implementation on TB screening and case detection.

§  Collected data from 637 health facilities from 2008 – 2011.

A trained health worker assists a TB patient on DOT, Baghlan province, Afghanistan, July, 2011

85,105 98,443

154,500

195,275

0

50,000

100,000

150,000

200,000

250,000

2008 2009 2010 2011

Nu

mb

er

of

Pe

op

le

Years

Number of People with TB Symptoms Screened for TB���

2008 – 2011

Results: SOPs Increase Screening and Case Detection

§  Assessment revealed a steady increase in the number ���of people with TB symptoms screened for TB from ���2008 – 2011.

§  Increases in the number of people screened for TB led to a 7% increase in TB case detection and notification in 2010, which sustained in 2011.

§  Total TB cases notified: v 2009: 26,258

v 2010: 28,238

v 2011: 28,138

Conclusion §  The SOP implementation resulted in a significant increase in

the number of people screened for TB and, in turn, TB case detection also increased.

§  SOP implementation should be scaled up in similar settings.