Project Goals Support the National Tb Program (NTP) Developed National Guidelines for prevention and
control of Tb Developed guidelines for treating people co-infected
with HIV/AIDS Implement and expand DOTS (Directly Observed
Therapy Short course) Strengthen Laboratories Strengthen the Capacity of Educational Institutions
Public Health Strengthening in Guyana
Implemented by the Canadian Society for International Health (CSIH) in partnership with the Guyanese Ministry of Health Canadian International Development Agency investment 5.5 million CN$
Poster AbstractPublic Health Strengthening in Guyana is a capacity development intervention focused on improving and maintaining the health of Guyana’s population. One major component of the Project focuses on improving the National Tuberculosis Program (NTP) by providing technical and administrative support for the NTP Unit, developing and implementing national diagnosis and treatment guidelines and, developing implementation strategies for directly observed therapy short-course (DOTS) using WHO standard treatment. To ensure the success of the project, organization and necessary procurement to introduce AFB laboratory diagnosis have been instituted. TB and bio-safety training sessions and laboratory manual development are completed. Mentorship, training and provision of motorbikes to DOTS workers have further ensured that great strides were made to improve level of patient plus family care. In 2001, there were 787 TB cases nationwide in Guyana. The TB detection rate was 54% for 2000. Moreover, the incidence of TB had increased by 10-20% annually between 1994 and 1999. In many cases, the extent of the problems was impossible to define because of the lack of diagnostic capacities, relevant expertise, and adequate staffing. Furthermore, many of the gains made from public health interventions, such as childhood immunization programs, have been eroded by the consequences of the increasing burden of HIV/AIDS, tuberculosis and co-infections.By supporting an integral approach to disease, prevention, diagnosis, management and care at the National and district/community levels, this project will result in overall improvement in health of the Guyanese.
Authors and Affiliations : Dr. Earl Hershfield, Tb expert consultant; Dr. Shamdeo Persaud, National Tuberculosis Officer Guyana; Ms. Roumyana Benedict, Project Director; Ms. Josée Levesque
Key Project Components:• Expanding and Strengthening the Prevention,
Management and Care of STIs/HIV/AIDS
• Improving National Tuberculosis Prevention and Control Program
• Strengthening the Health Information System
• Community Health Development and Care
TB in Guyana• 590 TB reported cases nationwide
(2003)• TB detection rate is 54%• DOTS (Directly Observed Therapy)
coverage is only 12% of the total population
• Annual rate of infection : 3.2 (estimated)
• Annual risk of infection : 0.92• TB infection : 14% (105,000 –
estimated)• Current prevalence : 0.3% (2,400
active cases)• Annual incidence : 79/100,000
(reported)• Mortality Rate (reported) : 3.25
Minister Ramsammy on a new DOTS bike provided by CSIH
Chief technologist and CSIH expert at new PHSG-funded laboratory
Consultation at Chest Clinic with NTP Director, Nurse and CSIH
expert
A CSIH consultant delivers a lecture at UGLaunch of DOTS expansion in region 10
Project Achievements Key persons trained on a study tour to Canada. Vehicle and administrative support provided for the
NTP Completed final draft of National TB Manual and TB
Laboratory Manual Eleven new DOTS workers trained, mentored and
provided with motorbikes Central Lab equipped and trained for TB culturing and
fluorescent microscopy Continuing Education sessions for medical
technologists The NGO Guyana Chest Society, re-activated and now
member of the IUATLD First National TB conference held in collaboration with
MOH and the Chest Society
Region 4
Region 10
Region 6
Guyana
Region 4
Region 6
Guyana
First National TB conference in Guyana, Oct. 2004 Computer and database training at Chest Clinic with CSIH
NetCorps intern
TB COMPONENT 0
200
400
600
800
Cas
es
0
20
40
60
80
100
Male
Female
Notified Cases 1988 - 2003
Case
s
Age and Gender Distribution 2003
www.csih.org/what/guyana/indexguyana.html
CSIH Guyana office:Suzanne MarquisProject Field ManagerTel: (592) 227 [email protected]
CSIH Ottawa office:Roumyana BenedictProject DirectorTel: (613) 241-5785 [email protected]
Chest Clinic Cured
Defaulted
Failure
Died
Georgetown 212 122 14 27New Amsterdam
16 8 0 6
Linden 9 4 0 7WDRH 7 7 1 1Total 244 144 15 37Percent% 43.7 25.2 2.6 6.6
Treatment Outcomes -2003
ACTIVITY 2003 2004
Hand Washing Non-existentFinding running water;Using wipes / antiseptic wash
Medication
Self-administered; Some DOTS in Georgetown onlyMeds carried in pillboxes
Directly Observed; Meds counted and packed in plastic bags
Drug DosagesDifferent dosages ; Varying length of tx ; Missing medications
Therapeutic dosages; Most treatments completed in 6 months
InformationPertinent information not consistently reported to MD
DOTS notes; Lab results posted; Improved documentation
Patient Education
Done at first visit only; Lack of teaching aids
Ongoing; Done with Family members; Teaching aids developed
Support Systems
Need for Support Systems identified
Support Systems continue to be insufficient
Statistics Not doneStandardization of format; properly reported
Sputum Collection
Patients went to the laboratory
Specimens collected at home by DOTS workers
DOTS Achievements 2003-2004
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