The plan of the project is to integrate TB with diabetes, Covid – 19, malnutrition and leprosy. Integration of these conditions with TB improves the prognosis of TB disease and vice versal. For example integrating TB and diabetes, if these two conditions will be identified together and finally managed together, a person will be likely to end up with good prognosis. TB disease is likely to manifest when a person has lowered body immunity. Thus, integrating these two conditions will provide the room for a particular person to be offered TB services and at the same time diabetic services to ensure good prognosis. TB disease is also the cause of malnutrition as well, malnutrition can cause lowered body immunity which increase susceptibility to TB disease. Again, symptoms and signs of Covid -19 and TB are likely to be the same, thus, when treating TB it is worth to exclude Covid – 19 in order to have good TB treatment outcome. However there are different types of TB (pulmonary TB and extra pulmonary TB) for this case there is also TB of the skin which may be confused with leprosy. Therefore, when treating TB of the skin, it is very important to exclude leprosy to ensure a good prognosis.
Through this project, PASADA will work in the community through the established Tuberculosis Rapid Assessment Posts (TRAPs). In TRAPs the proposed project will work with traditional healers, community health care workers (volunteers) who will be screening TB and leprosy. While screening corona, diabetes, and malnutrition will be done in health facilities. The community health workers, traditional healers, clinicians, DOT nurses and lab staff are experts on TB and they have been oriented on Covid – 19, thus before starting implementation of the proposed project they will need only a refresher training but also they will need to be capacitated on diabetes, malnutrition and leprosy self-assessment.
To ensure integrated services, all TB presumptive will be investigated for diabetes, Covid – 19, malnutrition and leprosy. Diabetic patients will be provided with nutrition education and how to practice
health behaviors, and those with severe form of diabetes will be referred for further management. Clients with history of weight loss will be assessed for malnutrition by using BMI (Body Mass Index) for adults and for children we will assess them by weight for age. For clients who will be found to be malnourished will be given therapeutic food or supplementary food according to severity. Clients who will be found to have covid -19 will be managed accordingly or referred as needed, while those with skin diseases will be managed and with leprosy will be referred for further management.
Objective of the project
Screening TB, Corona, Diabetes,
Malnutrition and Leprosy in an integrated approach in clinical partnership
program established community based Tuberculosis rapid assessment points (TRAPs)
Activities that have been handled.
· Community sensitization on accessing TB services and sputum sample collection, corona testing, malnutrition, diabetes and leprosy self-assessment.
· Strengthening of Tuberculosis Rapid Assessment Posts (TRAPs) using 50 community volunteers and integration of Diabetes, Corona, malnutrition and Leprosy screening.
· Sputum sample collection by traditional healer
· Training for HCW and Volunteers on TB refresher, and Corona
· Training for HCW and volunteers on Diabetes and Malnutrition
· Training for HCW and volunteers on Leprosy self-assessment
· Development of electronical data collection tool
· Training of volunteers on electronical data collection
· Strengthening diagnostic centres to be able to diagnose TB, HIV and diabetes.
· Procurement of lab consumables (gloves, mask, cotton) diabetic kits, corona kits for diagnosis of diabetes and Covid-19)
· Provision of therapeutic/ supplementary food to people with TB who have malnutrition.
Project achievement i.e. Measured on target / or by percentage or overall Target
- Establishment of 49 TRAPs out of 50 planned (98% achievement) . These TRAPs are run by community health volunteers, drug sellers and traditional healers.
- Through this project PASADA has been able to reach the community by improving access to TB services through community sensitization.