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Improving the health of the population in Romania by increasing TB control

Project financed by the Norwegian Grants 2009 - 2014, within the RO 19 - Public Health Initiative.

The provision of continuous, complete and quality treatment for 1 000 patients with MDR/XDR TB

In November, the enrolment of patients continued in the two MDR TB centres in Bucharest and Bisericani, as well as in the other TB facilities in the country involved in the project. As such, a total number of 774 patients were enrolled under complete, correct and continuous project at the end of the month.

Also, monitoring visits continued at the dispensaries, laboratories and hospitals in the counties of Prahova, Brăila, Timiș, Mehedinți, Sibiu and Mureș. These visits included the verification of the rapid testing registers, of laboratory equipment and of patient treatment records, and recommendations were made concerning the submission of the cases to the MDR committees for analysis. Monitoring visits will continue.

In the first part of November, the medicines for MDR/XDR patients were imported. In accordance with the recommendations of the National Agency for Medicines and Medical Devices (ANMDM) included in the special needs authorisation, samples were collected for the quality testing of medicines originating from outside the EU.

The provision of integrated interventions for the prevention of TB transmission in poor communities and for the increase of treatment adherence

The lists of patients under DOT in the 6 counties where this project component is implemented have been updated, and the IEC caravans for the month of December 2016 have been planned. A monitoring visit was organised at the community worker training session in Bacău County.

20 caravans were organised in November: 2 in Călărași County, 4 in Giurgiu County, 5 in Bacău County and 9 in Olt County. 1 101 persons attended these caravans, of whom 82 Roma. So far, IEC caravans organised under the project provided information to 9 896 persons, among whom 1 478 Roma.

By the end of November, 1 620 gift vouchers had been distributed to community nurses and sanitary mediators who organised the IEC caravans between January and October 2016.

109 patients were enrolled in November 2016 for the provision of DOT. In total, since the commencement of the project, 825 patients have been enrolled for DOT, among them 116 Roma. This activity involved 281 DOT supporters, and patients were enrolled from 242 localities.

By the end of November 2016, 15 542 social vouchers had been distributed to patients, with 152 such vouchers still to be distributed. Also, 13 940 gift vouchers had been distributed to DOT supporters who monitored patients in the 7 counties between January and October 2016.

The establishment of a network of functional laboratories for the early detection of MDR/XDR TB

In November, testing using rapid diagnostic techniques for MDR/XDR TB was conducted in 20 laboratories in the National Programme for Prevention, Surveillance and Control of Tuberculosis (NPPSCT) network: NRL Bucharest, NRL Cluj-Napoca, TB laboratories in Bacău, Brașov, Constanța, Craiova, Sibiu, Timișoara, Iași, Baia Mare, Leordeni, Sf. Ștefan Hospital in Bucharest, Leamna, Călărași, Galați, Târgoviște, Drajna, Deva, Tg. Mureș and Focșani. As a result of the tests, 707 patients with sensitive TB, 40 patients with MDR TB and two patients with XDR TB were detected in November 2016.

In total, since the commencement of the rapid diagnostic activity (March 2015) and until the end of November 2016, out of 28 132 tested patients, 11 077 were detected with sensitive TB, 880 with MDR TB and 91 with XDR TB.

The provision of directly observed treatment and of incentives for TB patients treated in outpatient facilities in order to increase treatment adherence

At the end of November, the database comprising patients enrolled in the project for social vouchers intended to increase treatment adherence included 1 386 individual patients registered, of whom 1 208 met the eligibility conditions to receive social vouchers. Among these patients, 470 have been enrolled and have benefited from support under the project for approximately one year, while 270 patients have completed the treatment.

Other activities carried out in November

14 TB Infection Control training sessions were organised in the country, in the counties of Brașov, Satu Mare, Ialomița and Cluj.

Work has continued for the drawing up of the tuberculosis patient brochure.

Activities continued for the review of the Practical Approach to Lung Diseases national guide, which will establish the algorithm for the identification of TB suspects in the general population, the specialist referral, the involvement of the primary care network in tuberculosis care in Romania.