This Global Plan builds on the previous edition, which laid out priority actions for 2018-2022, informed by global commitments member states endorsed at the 2018 United Nations High-Level Meeting (UNHLM) on TB. The resource needs estimates from this Global Plan include resources needed for implement...ing TB care and prevention and R&D into new tools. This Global Plan has already informed the Global Fund Investment Case and the 2022 G20 deliberations on TB. It will serve as a key document for inspiring and aligning global advocacy efforts, such as for the upcoming UNHLM on TB in 2023.
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MSF provides treatment for HIV and tuberculosis (TB) in more than 20 countries around the world. The report Burden sharing or burden shifting? How the HIV/TB response is being derailed examines the situation in nine countries where MSF runs programmes: Central African Republic, Democratic Republic ...of Congo, Eswatini, Guinea, Kenya, Malawi, Mozambique, Myanmar and Zimbabwe. With a focus on the financial resources available, this report highlights the current risks and gaps in HIV and TB service delivery in these countries.
Given the findings of gaps in diagnosis, prevention and care services and dwindling resources, MSF calls for a robust assessment of the needs and the resource capacity of each affected country, and calls on international donors to ensure that the financial burden is shared, rather than shifted onto those countries worst affected by the diseases.
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The manual is written for clinicians working at the district hospital (first-level referral care) who diagnose and manage sick adolescents and adults in resource constrained settings. It aims to support clinical reasoning, and to provide an effective clinical approach and protocols for the managemen...t of common and serious or potentially life-threatening conditions at district hospitals. The target audience thus includes doctors, clinical officers, health officers, and senior nurse practitioners. It has been designed to be applicable in both high and low HIV prevalence settings.
Volume 2 provides a symptom-based approach to clinical care for acute and subacute conditions (including mental health). It provides short summaries of the management of diseases that affect multiple systems of the body, focusing on communicable diseases. It also includes the chronic or long-term management of HIV, TB, alcohol, and substance use disorders.
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NSP Review
Engaging with South Africa’s National Strategic Plan for HIV, STIs and TB Edition 7 July – August 2013
A publication of the Treatment Action Campaign and SECTION27
GeneXpert: An imperfect rollout
TB in South African prisons: Where to now?
Decentralising DR-TB care: How far alon...g are we?
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The goal of this addendum is to help management and staff
minimize the risk of TB transmission at facilities in resource limited settings in which a.) HIV-infected persons receive diagnosis, care, treatment,
and/or support, and b.) there is a high prevalence of HIV infection, both known
and... undiagnosed, in settings such as prisons, jails, other
detention centers, and drug rehabilitation centers.
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2nd edition. The 2018 Roadmap incorporates an additional critical population: adolescents. Despite making up 1 in 6 of the world’s people, adolescents have been largely overlooked as global momentum to address TB has grown. Spanning the ages of 10–19 years, adolescents are both at risk of TB and... represent an important population for TB control. They often present with infectious TB and frequently have multiple contacts in congregate settings, such as schools and other educational institutions. Nevertheless, few countries capture TB data in suitably age-disaggregated ways to allow full understanding of its impact in this group and even fewer provide the adolescent-friendly services our young people need to access diagnosis and care.
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The main objective of these guidelines is to provide guidance on up-to-date, uniform, evidence-informed practices for suspecting, diagnosing and managing various forms of extra-pulmonary tuberculosis (EPTB) at all levels of healthcare delivery. They can then contribute to the National Programme to i...mprove detection, care and outcomes in EPTB; to help the programme with initiation of treatment, adherence and completion whilst minimizing drug toxicity and overtreatment; and contribute to practices that minimize the development of drug resistance.
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This report presents an overview of the transition process in Azerbaijan, some sustainability aspects and challenges stemming from donor withdrawal from TB-related activities, along with recommendations on how to overcome transition-related difficulties and ensure sustainability.
Symptom-based integrated approach to the adult in primary care.
Primary Care 101 is a comprehensive clinical practice guideline that aims to equip nurses and other clinicians to diagnose and manage common adult conditions at primary level.
Tb; HIV; Asthma/COPD; cardiovascular disease; diabetes; M...ental health conditions; Epilepsy; Musculoskeletal disorders; Women’s health
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The main aim of these guidelines is to enable the central units of national TB and HIV/AIDS programmes to support districts to plan, coordinate and implement collaborative TB/HIV activities. These guidelines reinforce current medical understanding, that highly active antiretroviral treatment (HAART)... has decreased TB incidence of people living with HIV/AIDS. They are comprehensive, giving an overview of the range of activities that could be undertaken in high burden TB/HIV countries or where a rising prevalence of HIV might fuel TB. Activities highlight the need for comprehensive care, prevention and support for adults living with HIV/AIDS. Comprehensive TB and HIV care and prevention rely on full implementation of the DOTS strategy as part of a wide ranging HIV/AIDS care and prevention programme as well as collaborative TB and HIV programme activities.
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For full publication see: https://drtbnetwork.org/mdr-tb-patient-education-flipchart
This tool can be used to educate new patients about TB and MDR-TB. The healthcare provider should review the material together with the patient. A treatment supporter can also use this flipchart at community lev...el to reinforce the concepts covered.
Major concepts covered in the flipchart:
TB is a contagious disease, which means it can be spread from person to person.
TB generally lives in the lungs, but it can also infect other parts of the body.
If TB is left untreated, it can kill the patient.
TB can be cured with the right medicine.
The flipchart can be adapted and modified as needed. The Mongolian Anti-Tuberculosis Association has adapted the flipchart for use in physician counseling training and in training of community health workers providing home-based care.
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The first important change is a new priority ranking of the available medicines for MDR-TB treatment, based on a careful balance between expected benefits and harms. Treatment success for MDR-TB is currently low in many countries. This could be increased by improving access to the highest-ranked med...icines for all patients with MDR-TB.
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Following the encouraging initial results of the pilot project, the Ministry of Health is committed to increasing access to MDR-TB diagnosis, treatment and care. An expansion plan for the programmatic management of drug-resistant TB has been developed and forms part of the Five Year National Strateg...ic Plan for TB Control, 2011-2015. The long-term goals of the MDR-TB expansion plan are threefold:
1. Diagnosis of MDR-TB in all groups of patients at risk for MDR-TB
2. Diagnosis of MDR-TB in all HIV-infected TB patients
3. MDR-TB treatment for all patients diagnosed with MDR-TB under WHO-endorsed treatment protocols
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Multidrug-resistant tuberculosis (MDR-TB) and extensively drug-resistant
tuberculosis (XDR-TB) increasingly occur in resource-constrained settings.
In the context of a national response to MDR- and XDR-TB, health workers in
TB clinics (in district hospitals and some accredited health centres) wil...l need
to diagnose MDR-TB, initiate second-line anti-TB drugs, and monitor MDRTB
treatment.
Management of MDR-TB: a field guide was created to help health workers
carry out these tasks. It is a job aid that medical officers and TB nurses
are meant use frequently during the day for quick reference. This module
is closely related to other clinical guideline modules in the Integrated
Management of Adolescent and Adult Illness (IMAI) series. In particular, the
approach to chronic disease management is taken from General principles
of good chronic care in the IMAI series.
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These guidelines are designed for settings with limited resources to provide inexpensive and effective control strategies for prevention of TB transmission in health care workers (HCW).
Therapy for MDR-TB is extremely long, complex and burdensome to both patients and health care systems. A single diagnosis can require two years of treatment, or longer. When treating children, there are significant additional barriers treating children with MDR-TB. There is limited data on the pharm...acokinetics of second-line TB drugs in children, and almost none are in child-friendly formulations. Nonetheless, there is continued work on second-line drugs to fight MDR-TB. The Sentinel Project has created a complex set of dosing recommendations for administering second-line drugs to children
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The Millennium Development Goals (MDGs) showed
that global commitment and collective action
could significantly reduce the disease burdens of
three deadly communicable diseases: HIV/AIDS,
tuberculosis (TB) and malaria. The MDGs helped
focus efforts on these three deadly diseases
and leveraged ...disease-specific programmes and
financing, thus achieving significant progress.
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National Guidelines on Nutrition, Care, Support, and Treatment (NCST) for Adolescents and Adults
These guidelines are intended to:
• Establish a consistent set of nutrition interventions and recommendations aimed at managing and preventing undernutrition and overnutrition in adolescents and ad...ults, with a focus on people with HIV/AIDS and tuberculosis (TB) patients.
• Provide simple and clear guidance to service providers and managers on how to implement the nutrition interventions and recommendations at the various health care delivery contact points.
• Provide a framework for policymakers and development partners to use when planning nutrition interventions for adolescent and adults.
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The Call to Action calls on the G20 member countries to ensure continuity of high-quality treatment, care and support services and programming that address the needs of the most affected and vulnerable populations, for a more efficient and effective TB response.
The Democratic Republic of Timor-Leste has the highest TB incidence rate in the South East Asian Region - 498 per 100,000, which is the seventh highest in the world. In Timor-Leste TB is the eighth most common cause of death.
The salient observations are as follows:
In 2018, 487 (12.5%) of the... 3906 notified TB patients were tested for RR-TB and only 12 lab confirmed RR-TB patients were initiated on standard MDR-TB treatment of 20-months duration, (a 3-fold increase in RR-TB detection compared with 2017). This amounts to treatment coverage of only 17% of 72 estimated MDR/RR-TB among notified TB patients (3906) and 5% of 240 estimated incident MDR-TB patients as compared to 62% treatment coverage of 6300 incident drug sensitive TB patients estimated in TLS. The treatment success in the 2016 annual cohort of 6 MDR-TB patients has been reported at 83%. 80% of TB patients know their HIV Status with around 1% TB-HIV co-infection, 37/ 77 (48%) TB-HIV Co-infection Detected. Of the 387 PLHIV currently alive on ART, exact status on TB screening and testing is unknown. % of PLHIV newly enrolled in HIV care who received IPT is not known.
In 2018, the mortality rate for TB was 94 deaths per 100,000 people (1200 per annum) in TL with an increasing mortality trend (Figure 1), despite TB services being available for nearly two decades.
A survey of catastrophic costs due to TB (2016) highlights that 83% of TB patients are reported to be facing catastrophic costs due to the disease. This is the highest rate in the world.
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