Control and Prevention of Tuberculosis (CAP-TB)

Leading up to World TB Day 2014, the CAP-TB “Cover your Cough” campaign used creative social and mass media to reach patients, families, and communities ...
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Summary Report

Control and Prevention of Tuberculosis (CAP-TB) October 2012 to September 2015

Control and Prevention of Tuberculosis (CAP-TB) | October 2012 - September 2015

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SUMMARY

1

Overview

Background

The U.S. Agency for International Development Control and PreventionTuberculosis (USAID CAP-TB) project has been funded in Myanmar from October 2011 through December 2015. The overall goal of the CAP-TB project is to develop a model for multi-drug resistant tuberculosis (MDR-TB) control and prevention in the Greater Mekong Sub-region (GMS) of Myanmar, China, and Thailand, with impact on incidence and mortality from MDR-TB in these countries. The CAP-TB model is a patient-centered, community-driven approach to strengthen health systems with the overall goal to impact MDRTB control and prevention.

TB/ MDR-TB Risk Groups

MMP: migrant and mobile population ups PREVENTION AND EDUCATION PLHIV: people living with HIV DM: diabetes mellitus population DOTS success ENTION AND EDUCATION Elderly: > 65 years old HIV Community mobilization ccess Infection control TB/ MDR-TB Risk Groups nity mobilization Training of trainers and physician mentoring control MMP: migrant and mobile population PLHIV: people living with HIV of trainers and physician mentoring

CAP-TB Model

DM: diabetes mellitus

TB/ MDR-TB Risk Groups Elderly: > 65 years old

TREATMENT SUCCESS migrant and mobile population

PREVENTION AND EDUCATION

DOTS success Community mobilization Infection control Training of trainers and physician mentoring

PREVENTION AND EDUCATION

DOTS success Community mobilization Infection control PREVENTION AND EDUCATION Training of trainers and physician mentoring

MMP: DOTS success DIAGNOSIS Directly therapy (DOT) PLHIV: people living withobserved HIV Community mobilization RISK GROUPS Chest X-rays Community-based DOT DM: diabetes mellitus Infection control MMP, PLHIV, DIAGNOSIS bserved therapy (DOT) Elderly: > 65 years Early case detection Patient old education Training of trainers and physician mentoring DM, Elderly RISK GROUPS ity-based DOT Build TB lab capacity Living Support Package Chest X-rays DIAGNOSIS MMP, PLHIV, Early case detection ducation GeneXpert DM, Elderly Build TB lab capacitySUCCESS pport Package Chest X-rays Microbiology studies TREATMENT Early case detection GeneXpert Directly observed therapy (DOT) Build TB lab capacity Microbiology studies RISK GROUPS Community-based DOT GeneXpert MMP, PLHIV, Patient education Microbiology studies TREATMENT SUCCESS DM, Elderly DIAGNOSIS Directly observed therapy Living (DOT) Support Package RISK GROUPS Chest X-rays Community-based DOT TREATMENT INITIATION MMP, PLHIV, Second-line drug availability Early case detection Patient education DM, Elderly TREATMENT INITIATION Build TB lab capacity Living Support Package MDR-TB treatment guideline Second-line drug availability Package of services GeneXpert MDR-TB treatment guideline Microbiology studies Package of services

MENT SUCCESS

Strengthened Services TREATMENT

Existing Services Strengthened Services Added Services

Second-line drug availability MDR-TB treatment guideline Package of services

Existing Services

Effective MDR-TB control is a challenge for TB platforms and health systems, as evidenced by the large diagnosis and treatment gaps reported from global data. Despite progress since 2009, fewer than 41% of estimated MDR-TB cases worldwide were diagnosed in 2014, and the global success rate remains at 50%. Starting in 2012, the CAP-TB project developed a model for MDR-TB control using a “patient-centered” perspective to identify gaps in the health system. The CAP-TB model starts with finding presumptive TB and MDR-TB patients in the community; linking presumptive patients with the national TB system for early diagnosis and