The Democratic Republic of Congo (DRC) is gaining ground in treating tuberculosis (TB) patients, even as cases of drug-resistant TB rise. The United States Agency for International Development’s Integrated Health Program (USAID IHP) in the DRC partners with the country’s National Tuberculosis Control Program (PNLT, Programme National de Lutte Contre la Tuberculose) to combat this debilitating illness on multiple fronts. They work together to improve access to diagnostics, decentralize TB-detection tests, and build staff capacities to identify and treat TB.
But the DRC needed more widespread, grassroots efforts to identify potential TB patients and conduct follow-up for treatment, particularly in smaller towns and villages where TB can spread undetected. So USAID awarded more than $1 million in grants to non-government organizations (NGOs) for supervision and support to cut TB mortality and infection by 50 percent in nine target provinces.
In July 2021, the awards went to five NGOs: Ambassadeurs de Lutte contre la Tuberculose, Action pour la Promotion de la Santé de la Mère et de l’Enfant, Batwa Bemba, Club des Amis Damien, and Fond de Développent de Service de Santé.
Batwa Bemba has promoted better health—from HIV treatment to COVID-19 prevention—and women and children’s rights in Haut-Lomami province since 2010. The NGO is now intensifying its community engagement to tackle TB cases, said its national coordinator, Biguette Buntu.
“This project has allowed us to expand our work in the province, cover a greater geographic area and spend more time with the community,” Buntu said. “The more time you spend with the community and understand the problem, you can find solutions.”
The five NGOs receive tranches of grant funding after they meet milestones such as the number of TB samples delivered or pre-therapeutic examinations provided. Activities include close collaboration with local diagnostic and treatment centers to support patient care through direct clinical follow-ups, supportive supervision for doctors, and distribution of nutritional support kits. The grantees also help pay to transport sputum samples for testing, improving detection of multi-drug resistant TB cases.
Immediate results followed the July 2021 awards, as grantees began supporting active community case detection and the transport of specimens to GeneXpert testing sites. Average detection rates of multi-drug resistant TB rose from 86 cases detected the quarter before grants began (April-June 2021) to 154 per quarter following the launch of the grants (July- September 2021). Gains were maintained in the following quarter (October -Dec 2021) with 158 cases detected. Treatment rates also increased, from 73 multi-drug resistant TB cases that initiated second-line treatment before the grants to 124 and up to 136 the following two quarters. The grantees’ continued work plus USAID IHP’s investment in new GeneXpert machines will further increase detection rates.
USAID IHP, in collaboration with the Provincial Committee for Leprosy and Tuberculosis Control s, will maintain the TB notification rate above the target in the provinces of Haut-Katanga, Haut-Lomami, Kasaï-Oriental, Lualaba, and Sankuru and improve it in the provinces of the East region in particular. USAID IHP will do so by intensifying its technical support to extend the implementation of innovative strategies for the active search for TB cases. The project will focus on identification of cases of cough presenting in the healthcare structures by intensifying collaboration with other healthcare services (i.e., pediatrics, HIV, diabetology, pneumology, and nutritional rehabilitation). The project also will investigate contact subjects of TB patients by systematically involving community agents in raising awareness, guiding people presumed to be sick, and safe transport of sputum samples and laboratory supplies to the diagnostic and treatment health center.
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