World TB Day: Prevention and Care Services in Vietnam
Contributed by CRDF Global partner, Friends for International TB Relief (FIT)
Since 1982, March 24 has been recognized by the World Health Organization (WHO) as World TB Day. This day is an opportunity to raise public awareness about the health, social, and economic consequences of tuberculosis (TB) and highlight the need to continue efforts to end the global TB epidemic.
Through a U.S. Government Cooperative Agreement, CRDF Global’s consortium partner Friends for International TB Relief (FIT) is strengthening TB prevention and care services in Vietnam by implementing activities in line with the cascade of care model in the face of the COVID-19 pandemic. The project consists of three key activities: 1) community-based chest X-ray screening for TB among ethnic minority populations living in remote, mountainous areas, 2) piloting and evaluation of specimen transport to reduce the cost of diagnosing TB, and 3) provision of multi-week medicine dosing and remote TB care for people affected by COVID-19 social distancing restrictions and lock downs.
In December 2021, FIT conducted the first of six planned community screening campaigns in Lai Chau province. A second campaign was conducted in Ha Giang province in March 2021. At these screening events, an ultra-portable handheld X-ray system (Fujifilm Xair) was used to screen ethnic minority populations and a newly WHO-endorsed, battery-operated rapid molecular assay (MolBio Truenat) was used for diagnosis. People were screened by chest X-ray and those presenting abnormalities suggestive of TB were then tested using the point of care using the rapid molecular assay. Over 9,000 people were screened by chest X-ray, resulting in the detection of 59 people with TB. In addition, over 795 latent TB infection tests were conducted, and have linked 70 people to TB preventive therapy (TPT) to date. FIT expects to conduct two additional screening campaigns to be organized in the provinces of Hoa Binh, Gia Lai, Kien Giang and Quang Nam by September 2022.
FIT also conducted a time-and-motion study to estimate the cost of using project staff time to transport sputum specimens between health facilities and laboratories. This exercise was used to justify a pilot where sputum transport was outsourced to third-party rapid shipping service providers, such as Grab and the Vietnamese postal service. To date, over 2,000 specimens have been transported in the provinces of Ha Noi, Hai Phong and Da Nang at a cost rate which is 70% lower than when project staff were transporting the specimens. More importantly, this activity affords project staff additional time to focus on capacity building and TB prevention, such as engagement of healthcare providers and other stakeholders as well as patient counseling and adherence support.
The project’s third activity supported TB patients affected by social distancing restriction and lock downs associated with the COVID-19 response in Ho Chi Minh City. FIT conducted a rapid survey to assess the proportion of TB patients affected and the acceptability of mitigation responses. FIT then coordinated the delivery of a month’s worth of TB medicines to patients and created an electronic reporting tool for health workers to remotely check in with patients via phone or video calls. A total of 116 patients were provide with this form of remote support. As COVID-19 lockdowns and restrictions have been lifted, treatment adherence in ethnic minority communities has been supported among the TB patients diagnosed through screening campaigns in remote areas through remote treatment monitoring by locally recruited and trained community health workers.
CRDF Global is honored to be working with FIT who demonstrates measurable impact in contributing to the end of the TB epidemic. This partnership illustrates our commitment to partnering with governments and local organizations in enhancing outbreak preparedness, response, and recovery.