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Lessons learned in implementing community tb prevention programme in south west n igeria

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Lessons learned in implementing community tb prevention programme in south west n igeria

  1. 1. <ul><li>1 Bako J.C , 1 Kehinde D., 1 Faloye A, 1 Ojoye K, 2 Itodo G. </li></ul><ul><li>1 The Society For Family Health Akure, Nigeria, 2 Centre for Women and Children Development, Akure Nigeria </li></ul>Lessons Learned in Implementing a Community TB prevention programme in South West Nigeria
  2. 2. Background <ul><li>Tuberculosis has been identified as one of the major threats to People living with HIV (PLWH) accounting for the highest reported cases of illness and death. </li></ul><ul><li>Nigeria is 4 th among the twenty two high TB burden countries with cases of TB infection. </li></ul><ul><li>The infection rate in the country increased from 31,264 in 2002 to 90,307 in 2009. </li></ul>
  3. 3. <ul><li>The TB burden in Nigeria is further compounded by the re-emergence of Multi-drug Resistant Tuberculosis (MDR-TB). </li></ul><ul><li>This calls for the need to improve interventions preventing TB HIV co infection among PLWH and the general population. </li></ul>Background cont’d.
  4. 4. <ul><li>Society for Family Health, an indigenous non governmental organisation received funding from United State Agency for International Development (USAID) in 2008 to implement the STOP TB strategy. </li></ul><ul><li>The project aimed at improving access to TB prevention interventions for the poor and vulnerable Nigerians with major interest in Ogun, Ondo, Oyo, Lagos, Benue and Adamawa states. </li></ul>SFH’s Response
  5. 5. <ul><li>The intervention commenced with TB DOTS centres assessment to identify functional centres for referrals </li></ul><ul><li>IPC Guides were developed to educate and sensitise the general population and PLWHA on basic facts about Tuberculosis prevention, detection, treatment and control </li></ul><ul><li>Advocacy visits were paid to key stakeholders and community sensitisation and mobilisation programmes were carried out </li></ul>SFH Response cont’d.
  6. 6. Baseline assessments using In-depth Interviews/FGDs with health workers at the DOTS centers Community Mobilisation/Sensitisation through the State TBL coordinators – TBL Supervisors - Nursing officers of PHC – CDA Chairmen. Monthly tracking of referrals. Training/review meeting with IPC conductors. Production/distribution of IEC materials. Participation in Special events and Community TB outreach programmes using IPC conductors. Intervention Strategies
  7. 7. Findings/Results <ul><li>DOTS centres assessment revealed that - </li></ul><ul><ul><li>There are functional TB DOTS centres in Lagos, Ogun, Ondo and Oyo states. </li></ul></ul><ul><ul><li>Insufficient staff (Some DOTS have 1 to 3 staff who attends to an average of 15 to 20 clients). </li></ul></ul><ul><ul><li>Providers reported limited knowledge and skills to diagnose active and extra pulmonary TB and manage co-infected patients . </li></ul></ul><ul><ul><li>Acute shortages of TB drugs (especially for children) and delays in drug supply and resupply. </li></ul></ul>
  8. 8. <ul><li>Many people still do not know that TB is curable and treatable </li></ul><ul><li>IPC conductors reached 13,060 persons (5,395 males and 7,665 females) with TB prevention messages </li></ul><ul><li>Defaulters were followed up to ensure they re-establish contact with DOTS </li></ul><ul><li>IPC conductors referred 129 suspects out of which 47 were confirmed Acid Fast Bacteria (AFB) positive </li></ul><ul><li>All positive clients are currently on treatment in various DOTS centers </li></ul>Findings/Results cont’d
  9. 9. Lessons Learned <ul><li>Community TB - IPC interventions showed high levels of acceptance by community members </li></ul><ul><li>Attrition rates for conductors are lower if conductors come from the community, are identified and selected by the community, and are resident within the community </li></ul>
  10. 10. <ul><li>Poor awareness about TB symptoms and stock out of essential commodities including laboratory materials contributes to low TB case detected in Nigeria </li></ul><ul><li>Stigma particularly from health workers threatens treatment effectiveness and control and could increase the possibility of MDR-TB </li></ul>Lessons Learned cont’d
  11. 11. Possible Future Interventions <ul><li>It is necessary that Nigeria scales up collaborative TB/HIV activities </li></ul><ul><li>Efforts should be made to empower people with TB and communities and encourage partnerships, through advocacy, communication and social mobilisation </li></ul><ul><li>Staff training is an urgent requirement </li></ul>
  12. 12. <ul><li>Thank you for your attention </li></ul><ul><li>For further information, contact </li></ul><ul><ul><li>The Society for Family Health </li></ul></ul><ul><ul><li>P O Box 5116, Wuse, Abuja </li></ul></ul><ul><ul><li> , [email_address] </li></ul></ul>