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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.

Rapid testing of patients for Multidrug Resistant and Extensively Resistant Tuberculosis (MDR TB and XDR TB)

A total of 1,398 people across the country have been tested in the National Programme for Prevention, Surveillance and Control of Tuberculosis to control the TB epidemic (NPPSCT) laboratories network which were equipped within the project with the latest equipment for rapid diagnosis of Multidrug-resistant (MDR TB) and the extremely drug resistant tuberculosis (XDR TB). A number of 295 of them were diagnosed with sensitive tuberculosis, 16 were detected with MDR TB and one person with XDR TB.

From March 2015 to December 2016, a total of 12 815 people have undergone rapid diagnosis, of which 3,160 were diagnosed with TB, 272 with MDR TB and XDR TB 5.

The development of a national laboratories network for early detection of TB MDR / XDR

GeneXpert equipment was purchased and installed in the designated laboratories within the project: Iasi, Timisoara, Leordeni, Craiova, Constanta, Cluj-Napoca, Brasov and Baia Mare. After commissioning of the equipment, laboratory staff has been trained in using the equipment. Also in December, the first batch of kits GeneXpert was delivered to TB laboratories equipped with GeneXpert.

Regarding the acquisition of 44 safety cabinets for laboratories, the centralised procurement procedure is in the bid evaluation stage.

The 10 LED epifluorescence microscopes were purchased this month. The procedure for selecting the supplier was completed, the supply contract was signed  and products reception was made and two of the microscopes have been installed in the National Reference Laboratory (NRL) Bucharest. The two microscopes were put into operation and staff of the NRL Bucharest has been trained in their use. The remaining 8 LED microscopes will be installed in the following laboratories: Cluj Napoca, Iasi, Constanta, Timisoara, Bacau, Brasov, Craiova, Leordeni.

Three laboratories from the NPPSCT network – Bucharest, Cluj-Napoca and Galati – were equipped with Versatrek equipment, which were put into operation, and the staff has been trained in their use. The Versatrek supplies were purchased in December: the provider selection procedure was completed, the contract for delivery has been signed and reception of the products was made. For the purchase of IT equipment, the centralised procurement procedure is in the bid evaluation stage.

Strengthening the Capacity of the National Programme for Prevention, Surveillance and Control of Tuberculosis to control the TB epidemic

In December two training courses for staff were organized in Constanta and Baia Mare in order to strengthen the capacity of the NPPSCT. 41 people attended these trainings, and the total number of health professionals trained in the field of respiratory medicine through project has reached 549. Earlier this month, the direct purchase of services assessment ended and the training calendar has been updated for the month of January 2016.

Providing integrated interventions to prevent transmission of TB in poor communities and to increase treatment adherence

In December, three training sessions with the participation of Local Health Assistance services and Health Ministry were organized in Neamt, Botosani and Dolj, attended by a total of 160 people. There were three monitoring visits to these three training sessions.

It has also been prepared the documentation for the purchase of gift vouchers necessary to stimulate community workers who will ensure the support in providing integrated interventions to prevent TB transmission in poor communities and to increase treatment adherence. The procedure is in the stage of bid evaluation.

Ensuring the correct, complete and quality treatment of the patients enrolled and of those who receive incentives for maintaining adherence to treatment

60 medical records were analyzed by the MDR TB commissions doctors, and 25 of the patients received the recommendation to be enrolled in treatment. In December, no new patients were enrolled in treatment. The project team continued the steps to complete the dossier submitted to the National Agency for Medicines and Medical Devices in order to obtain the special needs authorization to import the anti TB drugs in Romania.

This month, from the total of 1837 patients considered eligible to be enrolled in the project, 654 had signed consent sheets until November 10th. Between November 11th and December 31st, 10 new patients sent full consent sheets. There are 647 patients enrolled in the project to receive incentives / social support. So far, 580 unique patients have received social support to maintain adherence to treatment.

Other December activities:

NPPSCT county technical coordinators were requested information about locations to place the UV lamps purchased within the project.

Preparations for next year TA missions of WHO experts continued, by identifying the periods, NPPSCT priorities and the experts to carry out those missions.

Data from interviews of the TB patients about their information needs were collected and centralized, in order to accomplish a booklet about TB who will address TB patients, vulnerable groups and the general population. Also, the procurement procedure of an audit firm was organized.