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Table of Contents
- Introduction
- News
- The Union World Conference on Lung Health - Cancun Dec 2009
- TB Advocacy Toolkit Nominated for Award
- What's New in the TB CAP Toolbox?
- Quote TB Light
- Tool to Estimate Patient Costs
- International Standards for Tuberculosis Care
- Laboratory Tools - Strengthening TB Laboratory Services
- Guidelines and Specifications for Managing TB Laboratory Equipment and Supplies
- SOP's on Implementation of TB/HIV Activities
- Guidance on the Management of TB in HIV Infected Children
- TB CAP Focus ‘TB/HIV Collaborative Activities’
- Highlights from the field
- Center of Excellence (CoE) for DR TB in East Africa
- Core Group Support
- HRD Scale-Up South Sudan
- Upcoming Events
- VACANCIES
1. Introduction
Dear Readers,
Welcome to the first TB CAP newsletter of 2010. Best wishes for 2010 from everyone at TB CAP PMU, KNCV, The Hague.
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2. News
2a. The Union Conference - Cancun 2009
TB CAP PMU attended The Union Conference in Cancun December 2009 and presented a wide range of sessions on current TBCTA projects. These included the 'Patient Centered Approach' package ('Quote TB Light', 'TB Literacy Toolkit', 'Patient Charter for TB Care' and 'Tool for Estimating Patient Costs').
The 'Laboratory Tools' package and the Management and Organizational Sustainability Tool for TB (Most for TB), along with an introduction to TB/HIV Tools, The Advocacy Toolkit and the second edition of 'The International Standards for Tuberculosis Care'. All these tools can be found on the TBCTA website: http://www.tbcta.org/library.
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2b. TB Advocacy Toolbox nominated for a PRWeek Award
The TB Advocacy Toolbox has made it to the list of PRWeek's 2009 Finalists, under the category of 'PR Innovation of the Year' which recognizes the best tools and applications designed for the use of the PR community and which have a lasting impact on the practice of PR, see the full details here [PDF - 2.26 MB]. The actual winner will be announced in New York City in March.
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3. What’s New in the TB CAP Toolbox?
The TB CAP Toolbox (CD Rom) contains key TB CAP materials. To receive a copy of the TB CAP Toolbox, please send an e-mail to pmu@kncvtbc.nl or visit our Web site at www.tbcta.org. Below are all of our new products:
3a. QUOTE TB Light [Zipped Package 2.7MB]
QUOTE TB Light is a simplified application of the original QUOTE TB tool (QUOTE is the acronym for Quality of Care as seen through the Eyes of the Patient).
It includes the same components as the original tool, but it is revised as a 'ready to use' package including standardized instruments for application, which make it more practical for use by all National TB Program staff to improve the quality of TB services and stay accountable to TB patients.
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3b.
Tool to Estimate Patient Costs [Zipped Package 7.4MB]
 By addressing barriers and reasons for delay to timely diagnosis and treatment by the NTP, costs to TB patients, particularly among the poor, can be effectively reduced. The Poverty Sub-Working Group of the Stop TB Partnership has therefore decided to develop a tool which can assist TB programs to estimate the costs of TB patients before and during diagnosis and during treatment by the NTP.
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3c. International Standards for Tuberculosis Care 2nd Edition (English) [PDF - 2.26 MB]
 The purpose of the International Standards for Tuberculosis Care (ISTC) is to describe a widely accepted level of care that all practitioners, public and private, should seek to achieve in managing patients who have, or are suspected of having, tuberculosis. The Standards are intended to facilitate the effective engagement of all care providers in delivering high-quality care. It has now been three years since the first edition of ISTC was written: new information has emerged; new approaches are now feasible; and new guidelines have been written. These changes warranted an updating of the ISTC to be consistent with the concept of a living document.
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3d. Laboratory Tools - Strengthening TB Laboratory
Lab Tools - Culture DST Course Participant [PDF - 6.93 MB]
Lab Tools - Culture DST Course Trainer Folder [PDF - 3.91 MB]
Lab Tools - Guidelines & Specifications [PDF - 3.29 MB]
Lab Tools - Management Information System [PDF - 841 KB]
Lab Tools - Microscopy & EQA [PDF - 6.38 MB]
Lab Tools - Standard Operating Procedures [PDF - 6.26 MB]
The newly released TB CAP Laboratory Toolbox contains the five products listed above which were developed to support countries in strengthening their laboratory services. To receive a copy of the TB CAP Laboratory Tools CD please send an e-mail to pmu@kncvtbc.nl or visit our website at www.tbcta.org/library where are the components can be downloaded.
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3e. Guidelines and Specifications for Managing TB Laboratory Equipment and Supplies [PDF - 1.34 MB]
This document is designed to provide guidance to governments, NTPs, donors and others responsible for the procurement, logistics and management of laboratory equipment and other commodities used in TB laboratory services.
Such services include reliable TB microscopy and culture and drug susceptibility testing. The document will be useful in developing systems for the efficient and timely procurement of quality laboratory equipment/supplies and the ongoing management of all TB-related laboratory commodities.
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3f. SOP's on Implementation of TB/HIV Activities [PDF - 4.53 MB]
 Standard Operating Procedures (SOPs) have been developed and proven effective as a resource in the HIV care the treatment community. Based on this success, these SOPs were developed to provide direction in providing combined TB and HIV/AIDS services at the HIV care site.
The synergy found in treating these diseases concurrently is what distinguishes these SOPs from other TB or HIV-specific guidelines.
These SOPs are essential to providing equity of care, patient safety and standardization of service provision for this at risk population.
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3g. Guidance on the Management of TB in HIV Infected Children [PDF - 653 KB]
 Guidance for national tuberculosis and HIV programs on the management of tuberculosis in HIV-infected children: Recommendations for a public health approach.
The synergy found in treating these diseases concurrently is what distinguishes these SOPs from other TB or HIV-specific guidelines.
These SOPs are essential to providing equity of care, patient safety and standardization of service provision for this at risk population.
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3h. TB CAP Focus - TB/HIV Collaborative Activities [PDF - 1.4 MB]
The latest version of TB CAP Focus looks at what TB CAP is doing in the field of TB/HIV Collaborative Activities.
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4. Highlights from the Field
4a. Center of Excellence (CoE) for DR TB in East Africa
Currently many countries in the African region are embarking on the diagnosis and treatment of drug resistant TB (DR TB). TB CAP has recognized that they is an urgent need for centers in African which can provide example of best practice in the African environment, including the overlapping HIV and TB epidemics, standardized diagnostic practices, treatment protocol and infection control policies. To this end TB CAP, working through KNCV and in collaboration with the WHO has been working on the establishment of a Centre of Excellence (CoE) in the Programmatic Management of Drug Resistance TB (PMDT) in East Africa. Significant progress has been made towards this. A meeting with the participation of NTP manager/representative of NTP and the MDR focal person for the NTP from Kenya, Rwanda and Tanzania was held in Nairobi, Kenya on 18-19 June, 2009.
Objectives, terms of reference, criteria and selection procedure were discussed and agreed. The letter of intent for the establishment of CoE was submitted by Kenya, Ethiopia and Rwanda. The assessment of these three countries for their preparedness for CoE was done by a team of consultants from KNCV Regional Office at Nairobi, Kenya, RCHQC, Uganda and PMU, TB CAP/TBCTA at the Hague from August 27 - September 4, 2009. Based on the evaluator’s report Rwanda has been selected as the site for the development of CoE in East Africa and in the first week of November 2009, consultants from KNCV visited Rwanda to have a meeting with the stake holders for the establishment of CoE.
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4b. Core Group Support
One of TB CAPs priority projects is to provide support to the CORE Group, a network of 50 U.S. based organizations with a focus on community-based public health practices. During the past year, TB CAP supported four mid-term and final evaluations of USAID funded TB projects implemented by CORE Group member organizations in Mexico, South Africa, Malawi and Indonesia.
The four evaluations have resulted in a collection of successful approaches and lessons learned from each of the projects. In the coming year, TB CAP in collaboration with the CORE Group will develop a document highlighting the most important issues to be shared with our partners in the global TB community.
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4c. South Sudan: HRD Strategic Planning
Ineke Huitema HRD coordinator with TB CAP recently visited Southern Sudan. The visit was part of the TB CAP South Sudan plan, to develop a strategic HRD plan for TB control in line with the strategic plan for Human Resource for Health (2007-2017) and the National strategic plan for TB control.
Meetings were held with stakeholders and care providers at different levels to assess the HRH situation in general and in TB control in particular. Field visits were conducted to Yei and Wau and in total 4 hospitals were visited with TB services and 2 primary health care centers (PHCC).
The main purpose of the visit was to identify prevailing HRH constraints as input for the HRD strategic plan.
At this moment only 25% of the population has access to health services and of the services available only 40% of them are providing TB services. With the expansion of services more health staff need to be trained on the basic health care packages including TB services.
Initiatives at National Level
At National level several initiatives have taken place to improve the quality and quantity of health staff. A HRH strategic plan has been developed and the next step is to develop the corresponding implementation plan. It is proposed that training be harmonized for all categories of staff at all levels including the set-up of a training structure, the training will be based on training needs (in quality and quantity).
Structure
At this moment only the state of 'Central Equatoria' has a both a State TB coordinator and a State TB supervisor, the plan is to have State TB coordinators and supervisors in all 10 states. It will be part of the HRD strategic plan for TB control to specify the competences needed for this cadre of staff, qualifications, job descriptions, training needs and how to build, maintain and update their knowledge and skills.
Quantity and Quality of Staff
Although only a limited number of facilities were visited it was observed that there is a lack of qualified nurses, clinical officers and lab technicians, especially in remote areas, however the staff currently working in the TB units are very committed and want to serve their communities.
Training of Health Staff
Interviews showed that there is a strong need for more training institutions which train health staff to diploma level instead of just certificate courses. The training levels of the health workers working in TB control vary greatly: some were well trained through international courses in Ethiopia (ALERT) and Arusha (The Union) whilst others only had received on the job training.
Malteser Hospital
In the southern most town of Yei the Malteser Hospital (which specializes in treating tuberculosis, sleeping sickness and leprosy), is handing over its TB activities to the Government so time was spent looking at the activities undertaken there and what was contained in the handover/exit strategy. The hospital provides a wide range of TB services including in-patients, outreach activities, food support and health education, it has high quality staff (with a low turn-over) and it was the only place where the team saw a 'Continuous Medical Education' (CME) session, which are organized for all staff members on a weekly basis. Malteser International has made a handover/exit strategy and a plan for further capacity building of Government staff to take over their activities.
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5. Upcoming Events
Hospital DOTS Linkage Action Plan Development Workshop:
The TBCTA Regional Training Centre Asia, will organize a Hospital DOTS Linkage Action Plan Development Workshop on 25-30 January 2010 in Yogyakarta, Indonesia. Public-Private Mix focal points from high-burden countries who are directly involved in implementation of Hospital DOTS Linkage activities are invited to participate, as a group of 4 to 5 persons per country. http://tbcta.med-gmu.org/.
Union North American Region Meeting
The 14th Annual Union North American Region Meeting will be held in Orlando Florida on 11-13 March at the Rosen Plaza Hotel. General Session topics will include:
1) TB-HIV Co-infection: A Sum Greater than Its Parts
2) Basic Science: From the Bench to the Bedside
3) Social Determinants of TB Transmission
4) Diagnosis and Treatment
5) Assessing the Roles, Results and Confounders of Newer Laboratory Methods
Related sessions will include a Stop TB North American Meeting, the annual Stop TB USA Advocacy Session, the annual Nursing Assembly, a Latin American Liaison Meeting, and plenty of networking opportunities as well as a 'Clinical Conversations' session where clinicians and others to discuss challenging cases. http://www.bc.lung.ca/lungdiseases/tuberculosis_iuatld.html.
World TB Day
World TB Day, 24 March, is about celebrating the lives and stories of people affected by TB: women, men and children who have taken TB treatment; nurses, doctors, researchers, community workers; anyone who has contributed towards the global fight against TB.
The year 2010 marks the halfway point for the Global Plan to Stop TB (2006-2015), the theme this time is 'Innovation' and the slogan is 'On The move against Tuberculosis, Innovate to accelerate action' visit: http://www.stoptb.org/events/world_tb_day/2010/
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6. VACANCIES
TB CAP is regularly recruiting staff. For vacancy listings, please see the TB CAP Web site (www.tbcta.org) or the Web sites of TB CAP partners.
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Contact
For any questions, comments or suggestions please send an email to: pmu@kncvtbc.nl
To (un)subscribe to the TB CAP newsletter please send an email to: baylyt@kncvtbc.org
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American Thoracic Society (ATS)
