27 Jun Nigeria: Gombe State Agency for the Control of AIDS (GomSACA) screens internally displaced persons for TB
[vc_row css_animation=”” row_type=”row” use_row_as_full_screen_section=”no” type=”full_width” angled_section=”no” text_align=”left” background_image_as_pattern=”without_pattern”][vc_column][vc_separator type=”normal” thickness=”2″ up=”20″ down=”20″][/vc_column][/vc_row][vc_row css_animation=”” row_type=”row” use_row_as_full_screen_section=”no” type=”full_width” angled_section=”no” text_align=”left” background_image_as_pattern=”without_pattern”][vc_column][vc_gallery type=”nivo” interval=”3″ images=”2776,2775″ img_size=”full”][vc_column_text]Since the outbreak of the Boko Haram insurgency, over 2 million people have been uprooted including about 1.8 million Internally Displaced Persons (IDPS) in north-eastern Nigeria. 152 IDP camps and 1,113 host communities have opened in Adamawa, Gombe and Yobe States.
Due to poor housing, overcrowded living conditions, malnutrition and limited access to care, IDPs and refugees are exposed to greater risk of contracting illness, especially TB and HIV. Despite the increased presence of humanitarian organizations in the region, TB (and HIV) service delivery has not been a priority. Additionally, the State TB Programmes have not been able to extend TB services to this vulnerable population due to limited resources.
In June 2017, the Gombe State Agency for Control of AIDS (GomSACA), through Stop TB Partnership’s Wave 5 TB REACH Grant, set up a project to detect additional TB cases in IDP camps and host communities in 12 Local Government Areas (LGAs) across 3 north-eastern States of Adamawa, Gombe and Yobe.
The GomSACA project team in collaboration with 4 community-based organizations (CBOs) conducted a detailed mapping of IDP camps and host communities, TB and HIV service delivery points and humanitarian organizations in the targeted area for the intervention.
Identified healthcare workers (HCWs) and community volunteers (CVs) were trained while the CBOs mobilized the IDP communities for the intervention through small awareness campaigns.
Field screening was conducted by CBOs with the help of 180 CVs (15 per LGA) across the 3 States. House-to-House TB screening was conducted in host communities, Tent-to-Tent TB screening was conducted in IDP Camps while community outreaches were conducted across IDP Camps and Host Communities. The CVs and HCWs were responsible for the project under direct supervision of the CBOs, the State and LGA TB Teams. CVs conducted verbal screening for presumptive TB cases, sputum collection and transportation for diagnosis with Xpert, retrieval of results and active linkage to treatment, care and support. Furthermore, selected HCWs and CVs performed contact examination under the guidance of LGA TB Supervisors.
Bacteriologically negative and childhood (under 5 years old) presumptive TB cases were referred to clinicians in secondary health facilities for further evaluation. Supervision and monitoring were jointly conducted by the CBOs, State and LGA TB Teams and the State Agency for Control of AIDS.
The project successfully screened a total of 283,556 IDPs out of which 19,652 (6.9%) presumptive TB cases identified and referred for GeneXpert diagnosis.
Out of 17,134 people who were tested for TB, 1,423 all forms TB were identified, with 1,254 (6.3%) being Bac+ TB cases and 35 drug-resistant cases. 1,415 patients were started on treatment.
Furthermore, 2,025 contacts of confirmed cases were screened and 56 of them (2.3%) were confirmed Bac+. In addition, 22,596 IDPs were screened for HIV of which 215 (1%) were found to be HIV+.
The overall case notification for the area increased by 16.5% compared to the same period of the previous year.
This success has led to the project’s inclusion in the Global Fund support to the country which is expected to commence in 2019 to 3 other States with a high number of IDPs. The increasing inflow of IDPs into the project area and the existing gaps between TB (and HIV) diagnosis and linkage to care highlights the urgent need to scale up this intervention. The scale-up to additional LGAs across 4 States – including Borno – was supported by TB REACH for another round allowing the project to sustain its ACF activities across the north-eastern States while awaiting Global Fund funding.
Addressing gender barriers
This project focused its interventions in addressing the barriers to health services that women are more likely to encounter during TB screening and linkage to care. These include religious and cultural factors which could hinder male community volunteers (CVs) from accessing the host communities – especially during house-to-house screening for TB and HIV. The project ensured to include women among the CVs and to engage female leaders in the IDP camps and host communities. This helped to improve women and children’s access to TB and HIV screening in this project. The female leaders in the communities played a key part in mobilizing women, especially during mass screenings and house-to-house (and tent-tent) screenings in the IDP camps and host communities. In an effort to further improve access of women to TB screening, the project also targeted maternal and child health clinics in health facilities within the target population.[/vc_column_text][/vc_column][/vc_row]