Zaporizhzhia oblast

EPIDEMIC SITUATION: TB, MDR-TB AND TB/HIV

TB morbidity in Zaporizhzhia oblast was 59.0 per 100 000 in 2014.

The absolute number of TB cases and TB morbidity is decreasing. Over 1050 new TB cases are registered each year. The rate of TB detection by sputum smear microscopy is 3.1%, while Ukraine’s average is 2.2%.

Other key indicators are listed below.

TB morbidity ( new cases )

Region

Absolute number

Per 100,000

2012

2013

2014

2012

2013

2014

Zaporizhzhia oblast

1154

1112

1048

64.4

62.3

59.0

Ukraine

30958

30819

22821

68.1

67.9

53.2 

New confirmed MDR-TB / XDR-TB cases, 2014

Region

New confirmed MDR-TB / XDR-TB cases

Including those who started treatment in the reporting year

Confirmed MDR-TB case

Including XDR-TB

Total

Zaporizhzhia oblast

369

89

352

Ukraine

7855

1201

7540

TB mortality in Ukraine (according to the National Statistics Department)

Region

Absolute numbers

Per 100,000

 

2012

2013

2014

2012

2013

2014

Zaporizhzhia oblast

301

278

285

16.8

15.6

16.1

Ukraine

6862

6390

5240

15.1

14.1

12.2

TB/HIV morbidity

Region

Absolute numbers

Per 100,000

2012

2013

2014

2012

2013

2014

Zaporizhzhia oblast

187

168

211

10.4

9.4

11.9

Ukraine

7456

6599

6216

16.4

14.5

14.5

HIV positive people are 10.9 percent of all TB cases in the region. The rate of TB patients tested for HIV in 2014 was 95.3%. TB is the main cause of death of among PLHIV/AIDS. 

HIV (AIDS)-associated TB mortality

Region

Absolute numbers

Per 100,000

2012

2013

2014

2012

2013

2014

Zaporizhzhia oblast

67

71

65

3.7

4.0

3.7

Ukraine

2,786

2,522

1.994

6.1

5.6

4.6

 

COLLABORATION WITH THE USAID “STRENGTHENING TB CONTROL IN UKRAINE” PROJECT 

Zaporizhzhia oblast became a USAID pilot site in 2005. The project substantially contributed to overall improvements in TB detection, diagnosis, and treatment and focused on:

  • Strengthening health service providers capacity to diagnose and treat TB based on international standards
  • Developing a policy and legislative base for TB control;
  • Building laboratory capacity in smear microscopy and drug sensitivity testing;
  • Implementing targeted community mobilization strategies;
  • Introducing approaches to effectively monitor TB program performance and utilize surveillance data in TB program management.

The USAID Strengthening Pharmaceutical Systems (SIAPS) project is also supporting the implementation of e-TB Manager, an electronic TB register aimed at improving TB reporting and recording system.  The project supported infrastructure development, users training and support, regulatory support of the implementation and coordination with the counterparts. The next step is to ensure quality of data entered into e-TB Manager. This task will be taken over by a new four–year USAID program Systems for Improved Access to Pharmaceuticals and Services Ukraine managed from Washington and monitored by USAID/Ukraine. 

 

THE USAID STRENGTHENING TUBERCULOSIS CONTROL IN UKRAINE PROJECT

In April 2012, USAID launched the $17.8 million Strengthening TB Control in Ukraine project, implemented by Chemonics International, Inc. in partnership with Project HOPE, the New Jersey Medical School and the Global Tuberculosis Institute. The project goal is to decrease the burden of TB in Ukraine through quality assurance and systems-strengthening measures for routine TB, MDR-TB, and TB/HIV co-infection services. Key project objectives are to:

  • Improve quality and expand availability of TB services based on international  recommendations;
  • Create safer medical environment at medical facilities based on up-to-date TB infection control approaches;
  • Build capacity to manage multi-drug resistant/extensively drug resistant TB cases;
  • Improve access to TB/HIV co-infection services.

Through USAID support, approximately 400 TB doctors, epidemiologists and laboratory specialists from Zaporizhzhia have gained knowledge of updated, evidence-based practices in TB diagnostics, treatment, and prevention. Starting next year, USAID will support the Ukrainian Red Cross Society to help TB patients complete their full TB treatment through home visits by nurses who will deliver food packages to patients as an incentive. 

In 2014, all TB diagnostic laboratories in the Zaporizhzhia oblast successfully passed external quality assessment (EQA). Despite EQA is strongly recommended by the WHO, only the USAID-supported regions are totally covered with EQA procedure in Ukraine. Among them 32 laboratories (75 percent) demonstrated 100 percent accuracy in smear microscopy during the EQA process.

In partnership with the Ukrainian Red Cross Society, the USAID project provides DOT-based patronage to 30 TB patients monthly, helping TB patients in difficult life circumstances successfully complete their TB treatment course and prevent default. Red Cross nurses not only bring TB medication to a patient’s home, but also provide social and psychological support to patients and their surroundings.

Current challenges, which need special attention from the project:

  • The involvement of primary health care facilities and family doctors to TB control
  • Improving TB infection control measures in healthcare facilities in the oblast

Recent news on usaid project's activities in the Zaporizhzhia oblast