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Early TB detection and treatment efficiency

enhancement among the most at risk

populations in Ukraine

AIDS 2014, Melbourne22 July 201413:00-14:00

Zahedul Islam

International HIV/AIDS Alliance in Ukraine

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Epidemiology

84.1

83.279.8 77.8

72.7 68.4 67.2 68.1 67.9

29.234.4

38 40.9 43.2 44.7 46.2 45.5 47.6

4.3 5 6.3 7.4 8.7 9.1 10.4 10.5

0

10

20

30

40

50

60

70

80

90

2005 2006 2007 2008 2009 2010 2011 2012 2013

Incidence HIVIncidence TB Incidence TB/HIV

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Background

Pilot started in April 2013, Alliance provided support to 39 NGOs in all

regions of Ukraine.

Purpose: to decrease TB prevalence and mortality rate among MARPs

through early detection and timely unhampered access to medical

services.

The target groups of the project are FSWs, IDUs and IDU partners,

MSM and most-at-risk adolescents.

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Project DescriptionStarting from April 2013, 39 partner NGOs which implement harm-reduction programs, included early TB detection in their scope of services.

Preparation:

- Established partnership with healthcare institutions to create a mechanism of services provision for most

vulnerable population (e.g., PWID, CSW, MARA).

- Trainings for NGO’s social workers on

early TB detection and infection control measures

were conducted

Implementation:

- Screening questionnaires for early

TB symptoms

- Sputum collection on sites

- Referral to healthcare institutions

- Implementation of IC measures in NGO’s

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Early TB detection outcomes

10218

TB screening

5707

TB diagnostics

659

TB detection (all forms)

542

TB detection (newly

diagnosed and relapse)

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Challenges in TB diagnostics and

treatment

• Vertical structure of healthcare system and low availability

of the said services outside the TB service

• High level of stigmatization and discrimination of the

most-at-risk populations, especially IDUs, in the

healthcare system

• Low awareness on the importance of timely diagnostics

and treatment of TB, on possible ways to obtain these

services

• Chaotic lifestyle, low social and economic status and low

motivation of the clients to preserve their own health

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Conclusions/Next steps

• Active TB case detection in NGOs working with MARP’s (HIV-

infected, IDUs and others) has proven its effectiveness.

• Detection of TB in these groups exceeded the overall detection rate

in primary health care.

• Collaboration between the clinics and NGOs allowed to improve

access to TB care for most vulnerable populations.

• Starting from 2015 over 75 NGO partners will add active TB

detection component into their service package.

• Expansion of NGO based active TB detection will reduce the spread

of new TB cases and mortality among MARPs in Ukraine.