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49 th Union World Conference on Lung Health;

Integrated Provider Initiated TB and HIV Services among Internally Displaced Persons in North-eastern Nigeria. 49 th Union World Conference on Lung Health;. The Hague, Netherlands 26 th October, 2018. Dr Suraj Abdulkarim, Gombe State Agency For Control of AIDS (GomSACA). Outline.

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49 th Union World Conference on Lung Health;

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  1. Integrated Provider Initiated TB and HIV Services among Internally Displaced Persons in North-eastern Nigeria 49thUnion World Conference on Lung Health; The Hague, Netherlands 26th October, 2018 Dr Suraj Abdulkarim, Gombe State Agency For Control of AIDS (GomSACA)

  2. Outline • Background • Objectives • Intervention • Results • Challenges • Lesson Learnt and Next Steps

  3. Background GomSACA: • An Agency under the office of the Governor • Established to coordinate HIV/AIDS Response • Experienced working with multiple Stakeholders at all levels (Government & Non Governmental) • Successfully implemented World Bank Projects (HPDP 1 & 2) in the past • TB REACH Wave 5 Grantee; now scaling up • In consortium with Janna Health Foundation (JHF) and SUFABEL Community Development Initiative (SCDI) in NE Nigeria

  4. Background • Total Pop:7,143,989 • Evaluation Pop: 3,362,345 • Target Pop: 307,585 • Control Pop: 2,461,374 • No. of LGAs: 12 • DOTS centers: 91 • Xpert Sites: 12 • AFB Sites: 31 • ART Sites: 17

  5. Objectives • Primary: • To detect & notify additional TB cases among IDPs camps & IDPs Host communities in Adamawa, Gombe & Yobe States, North-Eastern Nigeria • Secondary (OR): • To assess knowledge and patient perceptions of TB and treatment seeking behavioramong IDPs • To estimate the prevalence of TB, HIV and TB/HIV coinfection among IDPs

  6. Stakeholders

  7. Key Approaches • Screening of IDP Camps & Host Communities for TB by CVs • Identification of Presumptive TB cases • Sputum collection and transportation for GeneXpert analysis • Childhood TB screening • & Transportation • TB Diagnosis & Linkage to treatment • TB Contact Examination

  8. Medical Officer

  9. Project Activity Pictures from IDP Camps & Host Communities

  10. Trends of TB Notifications (June 2017-June 2018): Bac +

  11. Trend of TB Notifications (June 2017-June 2018): : TB All Forms

  12. Key achievements • Case Finding • No of IDPs screened: 283,556 • No of Drug Sensitive TB: 1,253 • No of Drug Resistance TB: 38 • Contact Investigation • No. of Contacts Screened: 2025 • No of TB cases detected: 56 (2.3%) • HIV Screening • No of clients screened: 48,341 • No of HIV+ Detected: 223 • 2 LGAs re-activated in Yobe State • 3 (25%) non-functional GeneXpert equipment were reactivated • Increased utilization of GeneXpert equipment in the project area

  13. Operational Research- Why OR: • TB among IDPs is about twice higher than in the general population. • Low case detection in Nigeria • How has the experience of mass displacement affected the health-seeking behaviour of IDPs in the region? • What is the perception of the quality of TB and HIV services by IDPs • Data analysis is ongoing

  14. Preliminary Findings: • Knowledge gaps; Delays in accessing services (due to Social stigma)  • Alternative Health Care (often the first point of contact) • Poor access to Health Services including TB • Quality of Health (including TB) services (facility & Community based) from the client perspective was encouraging • Most TB patients were satisfied with services provided through CVs (especially House-to-House) • Household heads were more satisfied with female CVs screening their spouses rather than male CVs • The second OR question still being analyzed

  15. Challenges • Keeping up with new host communities • Identification of key stakeholders: • Stakeholder analysis is valuable • Initial compliance issues during House-to-House TB screening • Childhood TB diagnosis (<5s) • Distribution of CVs • Low capacity for HCT (among CVs) • Shortages of HIV Rapid Testing Kits

  16. Lessons Learnt and Next step • Collaboration/information sharing with camp managers/NGOs • IDP preference for Host Communities (90%) • The influence of Incentives • Ward Development Committees (WDCs): A potential for ownership. • Distribution of CV/Impact • IDP trans-border movement • Monthly data collection • More Host Communities identified by Project • More Targeting of HCs • New innovations include; • leveraging on the existing Ward Development Committees (WDCs • the provision of transport support for presumptive <5 childhood TB cases, • strategic distribution of CVs • Going Forward: • Scale Up • Multi-Country Project

  17. Acknowledgements – Project, ideas, input, (and ppt slides) Adamawa, Gombe and Yobe States Government NTBLCP McGill International TB Centre TB REACH / Stop TB Partnership Global Affairs Canada Jacob Creswell Marina Smelyanskaya Dr Stephen John 17

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