The Union World Conference on Lung Health concluded on Sunday, November 3, with a symposium on tuberculosis (TB) case detection strategies in sub-Saharan Africa. Moderated by MSH’s Global Technical Lead for TB, Pedro Suarez, the symposium began with a riveting presentation from Rhehab Chimzizi, the TB CARE I Project Director and Management Sciences for Health (MSH)’s Country Representative in Ghana. Rhehab outlined the strategies his team used to implement standard operating procedures (SOPs) for TB case detection at six large Ghanaian hospitals and then discussed the significant improvements that occurred at these hospitals. He emphasized that this low cost, simple intervention involved training just 120 health workers and, in 12 months, increased TB case detection by 46 percent and reduced TB patient mortality by 38 percent.
“Ghana has 213 districts and we only did this in two,” Rhehab told the room. “The point is, if we do this in all hospitals, the national TB case detection rate will go up and TB deaths will also go down!”
After his speech, the room buzzed with energy as Rhehab fielded questions from six of his colleagues. Many of the audience members had been taking notes during his speech and these health professionals asked Rhehab to elaborate on the causes of patient mortality, the study design, the implications for expansion, the staff trainings, and the patient treatment strategies. Rhehab answered each of his colleagues and invited further questions and discussion by referring participants to his contact information.
After Rhehab’s speech, the audience turned its attention to Habtamu Ayalneh, a TB and TB/TB Clinical Diagnosis Coordinator for USAID’s TB CARE I project in Ethiopia. Habtamu’s presentation showed how both the Help Ethiopia Address the Low TB Performance (HEAL TB) and TB CARE I projects have improved TB case detection in Ethiopia through health worker trainings, SOP development and distribution, TB patient contact screening, and staff supervision and mentoring. Habtamu also discussed how the projects are improving laboratory services in Ethiopia through by external quality assurance activities and enhanced recording and reporting systems. Slides detailing these interventions then led into results data showing a 1,034 percent increase in the number of TB suspects identified in the intervention areas and a 155 percent increase in the number of TB suspects examined.
Habtamu also shared data reflecting improved trends in the TB cure rate, diagnostic accuracy, and patients with multidrug resistant TB enrolled in treatment.
Audience members praised both Habtamu and Rhehab for sharing their project implementation strategies and one participant emphasized the importance of keeping these “bread and butter” interventions at the forefront of our discussions on TB prevention and control, especially at global conferences where innovation and technical research often take center stage. In line with this sentiment, Rhehab ended his talk by imploring the audience and donors to continue funding these critical interventions, even in, and especially in, countries where the TB epidemic is now more controlled.
“People are talking about zero TB deaths,” Rhehab said. “But let’s make sure that the zeros do not include zero funding – it should be zero TB deaths but more funding for TB control services!”
Rhehab and Habtamu’s presentations demonstrate their technical expertise, leadership capacity, and commitment to advocacy for improved TB control. Both presentations will be available below. The presenters are eager to engage in further discussions about their projects and findings.
Improving TB Case Detection in Big Hospitals in Ghana (PDF)
Authors: Rhehab Chimzizi, Bismarck Adusei, Angela Quaye, George Bonsu, Pedro Suarez, Frank Bonsu.
Improving TB Case Detection through Strengthening of the Health System in Ethiopia: From Pilot to Scale Up (PDF)
Authors: Habtamu Ayalneh; Muluken Melesse; Belaineh Girma.
For more information about the USAID-funded, TB CARE I project, led by KNCV Foundation with MSH and partners, visit: TB CARE I.
For more information about the PEPFAR- and USAID-funded, HEAL TB project, led by MSH and partners, visit: HEAL TB.