TUBERCULOSIS

TUBERCULOSIS

Tuberculosis (TB) is preventable, diagnosable, and curable. Panax has extensive experience of working at international, national, and local level to strengthen the capacity of health systems, national TB programs, and health managers to prevent the spread of TB and improve the lives of those affected by it. Familiar with STOP TB Partnership, we are cognizant of the goals of the post-2015 Global TB Strategy. Our experience can addresses elements of the health system. We consistently apply evidence-informed knowledge and technical expertise to highly complex environments and in resource constrained environments, where TB services are most desperately needed.

DRUG-RESISTANT TB

Multidrug resistant tuberculosis (MDR-TB) is a strain of TB that cannot be treated with the two most powerful drugs that are most often used to treat the disease. Extensively drug resistant tuberculosis (XDR-TB) is a form of the disease caused by bacteria that are resistant to several of the most effective anti-TB drugs. Today, MDR-TB and XDR-TB threaten to reverse the global progress made in TB care and control.
Drug resistance occurs when TB patients do not receive the correct treatment regimens or do not complete the full course of treatment. Nearly 10 percent of the world’s TB patients have MDR-TB and 9 percent of these patients also have XDR-TB. Although all forms of TB are highly contagious, drug-resistant TB can be particularly challenging to control due to a longer treatment period and more costly drug regimes.
To tackle MDR-TB and XDR-TB, Panax has the expertise to help national TB programs and ministries to implement MDR-TB programs that focus on an effective programmatic approach, a strong clinical management strategy, a well-functioning laboratory system, and a sound drug management system.
Once these components of a MDR-TB program are in place, we can then support national TB programs and ministries of health to:

  • Train health workers to effectively screen for, diagnosis, and treat MDR-TB
  • Expand MDR-TB prevention and care initiatives to include more women and children
  • Establish an MDR-TB patient tracking system
  • Implement the e-TB Manager to manage all TB program data
  • Improve health facility systems and expand community-based approaches for MDR-TB control
  • Conduct operational research on MDR-TB interventions, patient support, and treatment outcomes to inform future programming
  • Panax can has the expertise available to implement the Multidrug Resistant TB (MDR-TB) Cost-Effectiveness Analysis Tool, which compares the cost-effectiveness of different MDR-TB service delivery modalities to help program managers select those that produce the best results at the lowest cost.

  • Panax has experts which helped to design and install web based, TB Manager, a health systems strengthening platform for managing information needed by national TB programs that integrates data across most aspects of TB prevention and care, including reporting and follow-up on presumptive and confirmed TB and drug-resistant cases, medicines management, and laboratory testing.
  • Panax can help implement a model of MDR-TB care that can increase service delivery sites, renovation of MDR-TB treatment initiating centers and assiste with the enrollment of new MDR-TB patients on treatment. This can help reach the national target of treatment success rate for MDR -TB.
  • DIRECTLY OBSERVED TREATMENT

    The World Health Organization’s directly observed treatment, short-course (DOTS) strategy involves training community health workers to increase awareness, detection, and treatment of TB and brings services directly to the homes of those at risk for infection. This strategy engages community-level volunteers in elements of TB service provision and is known to be one of the most cost-effective approaches to TB control.
    In collaboration with international partners, ministers of health, district-level leaders, nongovernmental organizations, and community-based staff, Panax has extensive experience of implementing DOTS by:

  • Designing and managing national strategic plans for DOTS application, expansion, and sustainability
  • Developing and disseminating standard operation procedures for DOTS case detection and treatment
  • Recruiting and training community health workers to identify suspected cases of TB, provide DOTS, and refer patients in need of additional treatment to health facilities
  • Organizing and co-facilitating community-based TB awareness and stigma-reduction sessions
  • Strengthening national, district, and community-level DOTS recording and reporting systems
  • In the last two decades, the world’s largest cities have seen a surge in TB incidence, particularly in urban slums. Panax experts have implemented the DOTS strategy in densely populated, urban areas, and rural settings, which improves TB service delivery and involves health care providers in TB control efforts.
    Our teams have experience of work alongside national TB programs and local stakeholders to train urban health facility staff to identify symptoms, provide timely testing and treatment, supervise patients’ medication intake, and accurately register and report data. We also train these health workers to improve case detection by encouraging and facilitating testing for people living in close contact with TB patients.

    LABORATORY STRENGTHENING

    Laboratories play a central role in TB control, surveillance, diagnosis, and care. Strong laboratory services allow providers to detect TB, monitor treatment, and document results. Strong laboratory services also allow technicians to detect different types of the disease, including pulmonary TB, extra-pulmonary TB, multidrug resistant TB, and extensively drug resistant TB. Research to enhance treatment also depends on the precision of laboratory data.
    Despite the crucial role of laboratory services in TB control, millions of people are unable to access reliable laboratory services due to scarcity of trained staff, insufficient supplies, inaccurate technical procedures, and inadequate quality assurance protocols. Panax experts can help partners to support national TB policy design and improve laboratory management. We can also help and support efforts to collaborate with ministries of health and national public health programs to strengthen TB control plans, policies, and standards. Our experience includes:

  • Support to the National TB Reference Laboratory, providing oversight of the laboratory network, installation of GeneXpert machines, and distribution of microscopes. Provide training, supervision, and facilitation of external quality assurance to laboratories.
  • Panax has expertise available for external laboratory quality assurance services, improved quality of diagnosis, support to labs on sputum culture and drug susceptibility testing.
  • PEDIATRIC TB

    The World Health Organization (WHO) estimates that each year, children account for over 500,000 new cases annually and up to 80,000 children die from the disease. Due to missed diagnosis, these global figures likely underestimate the burden of childhood TB.
    Panax considers ending childhood TB a priority. We have experience of working with the government to improve the diagnosis and management of TB in children, to integrate childhood TB control activities into standard pediatric service packages, and contact investigation to identify children exposed to TB.
    We have experience of developing the national roadmap on prevention and control of childhood TB, providing training for health workers in the identification and management of TB in children.

    PHARMACEUTICAL MANAGEMENT

    The recent surge of drug-resistant TB has highlighted weaknesses in prevention, diagnosis, and treatment of the disease. For TB medicines to be effective, quality-assured drugs need to be taken in the correct doses and for the full duration of the prescribed treatment. However, significant gaps exist between what are known to be strong pharmaceutical management practices and their application by global initiatives and national TB programs. Even when countries are able to quantify their pharmaceutical supply needs, delays in the global availability of drugs, bottlenecks at the country level, or improper storage can prevent patients from accessing effective medicines.
    Panax has the expertise to help national and provincial programs, and organizations identify underlying pharmaceutical management challenges and design appropriate solutions to secure quality TB medicines. We develop tailored tools and training to help systematically collect data and improve decision making to effectively manage TB medicine supply.
    We have experts who have worked with a variety of partners to develop collective solutions, including international TB initiatives, donors, national TB programs, and the private sector.