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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 drug-resistant/extremely drug-resistant tuberculosis (MDR-TB/XDR-TB)

In July 2016, the enrolment of patients in the MDR-TB centres in the country continued, with the number of patients enrolled for complete, correct and continuous treatment under the project reaching a total of 628.

Also, the assessment of MDR-TB cases continued and recommendations were made for the referral of the cases to the MDR-TB committee with a view to their enrolment in the project.

The strengthening of the NPPSCT capacity to control the tuberculosis epidemics

By the end of July, 687 persons in the national tuberculosis network participated in the drug management, tuberculosis infection control and TB surveillance training sessions.

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

In July, 14 tuberculosis information, education and communication (IEC) caravans were organized: 4 in Călărași County, 3 in Neamț County, 3 in Giurgiu County and 4 in Dolj County. A total of 783 persons participated in these caravans, of whom 209 Roma. So far, 7,929 persons have been informed about tuberculosis within the project, of whom 1,142 Roma;

A total of 495 individual patients were enrolled for directly observed treatment, of whom 56 Roma. In July, 68 patients in the counties of Botoșani, Neamț, Dolj, Gorj, Giurgiu and Călărași were enrolled, all of them being monitored and due to receive the social incentives during the month of August.

By the end of July, 8,295 social vouchers amounting to RON 82,950.00 had been distributed to patients. At the end of this month, 127 social vouchers amounting to RON 1,270.00 were pending distribution to patients.

By the end of July 2016, 7,050 gift vouchers, amounting to RON 70,500.00, had been distributed to DOT supporters who monitored the patients in the 6 counties in the period January-June 2016.

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

In July, MDR/XDR-TB early diagnostic testing took place in 20 laboratories in the National Programme for Prevention, Surveillance and Control of Tuberculosis (NPPSCT) network: Bucharest NRL, Cluj-Napoca NRL, TB laboratories in Bacău, Brașov, Constanța, Craiova, Sibiu, Timișoara, Iași, Baia Mare, Leordeni, Spitalul Sf. Ștefan București, Leamna, Călărași, Galați, Târgoviște, Drajna, Deva, Tg. Mureș and Focșani.

The centralised data concerning the rapid testing conducted in the TB laboratories within the project in July 2016 show that 3,124 rapid tests were conducted using the LPA, MGIT and Verstatrek techniques, 695 patients being detected with sensitive TB, 71 with MDR-TB and 23 with XDR-TB.

In total, from the beginning of the project and until the end of July 2016, 35,298 rapid tests were conducted, with 21,394 individual patients being tested. Of these, 8,334 were detected with sensitive tuberculosis, 709 with MDR-TB and 84 with XDR-TB.

Also this month, the summarizes procurement procedures were started for 2 Genexpert systems, 1 MGIT equipment and 6 centrifuges, as well as for 2,896 LPA and 5,600 MGIT tests required in order to ensure the continuity of the rapid testing activity in the TB laboratories. Also, new summarized orders for Genexpert and Versatrek tests were sent to the TB laboratories.

As regards the 44 biosafety cabinets (safety fume hoods) for the laboratories, in July, 29 size-A fume hoods were accepted under the supply contract, and delivery, installation and training of the staff for the use of size-A fume hoods were commenced (27 fume hoods were already installed and commissioned at the end of the month); the production of size-B fume hoods, which are to be accepted the following month, also began.

In July 2016, the tender specifications were drawn up for the procurement procedure concerning IT equipment: 2 IT servers required for the administration of the national software for the registration, monitoring and reporting of TB/MDR-TB cases.

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

In July, 843 patients met the eligibility conditions to receive social vouchers for the increase of treatment adherence, of whom 160 patients are under complete treatment, have concluded their treatment or have been declared cured, while over 258 patients have been enrolled and have been benefitting from support under the project for approximately one year.

Other activities conducted in July:

In July 2016, the 15th TB infection control (TBIC) training session was organised. Also, the documentation related to the organisation of the training courses was drawn up. Results: 281 persons trained with regard to TBIC.

The provision of technical assistance by the World Health Organisation (WHO) for the improvement of NPPSCT management: the TB infection control and human resources missions were organised in July.