USAID’s ACTB Program
HEED Bangladesh has achieved commendable success in Tuberculosis control but till now there are many gaps due to remoteness, inaccessibility, lack of awareness, lack of human resource, superstition etc. USAID’s Alliance for Combatting TB in Bangladesh (ACTB) has designed to increase case detection rate to 90% in the implementing area. HEED Bangladesh has designed this project which is mainly targeted on tea garden, punji (Ethnic Village) community which are socially distracted and the people living there have hardly any interaction with the mainstream population areas. The project has designed to incorporate vulnerable people like women, tea labors, ethnic minority, students, by different interventions to aware them. Screening tool has been developed for early case detection and further referral. New intervention, new strategy and lesson learnt from previous and ongoing projects have been incorporated to identify more TB cases which will supplement to achieve the government goal regarding TB. Duration of this USAID’s ACTB project is four years March 2020 to September 2023 and the project has already completed two years nine months successfully.
Achievements:
During this period, HEED Bangladesh tested 20,281 TB presumptive and diagnosed 2,850 TB cases [Bacteriologically Conformed: 2,107 (73.93%), Clinically Diagnosed: 679 (23.82%) and EPTB: 64 (2.25%)] through different screening programs and household visits and the treatment of all TB patients have been ensured.
- Four Meeting with meeting with Govt. health service provider were conducted and total 100 health service providers participated.
- Five Coordination meeting with garden based higher authority were conducted and 159 participants participated in those programs.
- Eighteen Orientation of tea garden health workers on TB were conducted and 441 tea garden health workers participated in those programs.
- Fifteen Mobilize tea garden health workers for screening of TB and referral of presumptive were conducted and 132 participants participated in those programs.
- Seven Coordination meeting on TB with ethnic group leaders were conducted and 188 participants participated in those programs.
- Eighteen Networking and Collaboration meeting with DOT providers were conducted and 547 participants participated in those programs.
- Three Establish linkage with nearby DOT centres were conducted and 22 participants participated in those programs.
- Through different screening programs total 32753 people were screened, 2204 presumptive were tested and 103 TB cases were diagnosed.
- Through miking on TB at hat bazar area for sputum collection 4681 people were screened, 348 presumptive were tested and 14 TB cases were diagnosed.
- Through POT song on TB (folk song) 1823 people were screened, 11 presumptive were tested and 2 TB cases were diagnosed.
- Through world TB Day 4200 people were screened, 75 presumptive were tested and 2 TB cases were diagnosed.
- One Awareness building and conduct active screening among school authority and students were conducted and through this program 60 students were screened but no TB cases were diagnosed.
Success Story 01:
Mrs. Shamoli Chasha (age 35), has been suffering from cough, night fever, weight loss for almost one month in Tiprachora Tea Garden of Sreemangal, Moulovibazar. She consulted with compounder in tea garden dispensary and took some medicine but did not get cured and her health condition became worse day by day.
As a part of regular household visit Community Facilitator of USAID’s ACTB Project came across her house. Community Facilitator observed her conditions & screened her along with her family members. Edison Rony Mondol, Community Facilitator, selected her as a TB presumptive & provided her with a sputum pot instructing her to collect her early morning cough in it. After being tested in microscopy she was diagnosed as TB patient and was called at the Sreemongal UHC DOT center for treatment. Dr. Ajonta Debi, Medical Oficer of Sreemongal Upazilla Health Complex, started her TB treatment in every morning according to her weight. Mrs. Shamoli Chasha was diagnosed as a case of Bacteriologically Confirmed TB (TR 558/21) according to National Guideline, contact tracing of her family members was done but in sputum test of her family members result was negative. Mrs. Shamoli Chasha started her medicine and felt some symptoms like weakness, joint pain and orange color urine in the first two months but after two months her health condition started to improve. Her DOT provider was very sincere and helped her to take medicine in every day. After taking full treatment in six months she cured completely and her health condition is very good at present. She & her family members have expressed cordial gratefulness to the USAID’s ACTB HEED Bangladesh for their support.
Success Story 02:
Mrs. Durgamoni Bawri, 29 years, lives in Chatlapur Tea Garden of Kulura, Moulvibazar district. She was suffering from cough, fever, and loss of appetite for nearly a month, so she became very weak day by day.
She had taken some medicine from local village doctor but there was no improvement of her condition. USAID’s ACTB Project, HEED Bangladesh’s Community Facilitator ‘Mr. Muhibul Islam Sunnah’ suspected her as a TB symptomatic through screening. Then Community Facilitator provided sputum pot and counsel her how to provide early morning sputum, the next day her sputum was carried via sputum preservation box to Kulaura Upazilla Health Complex. After being tested in microscopy she was identified as a bacteriological confirmed TB patient. Next day, the patient went with her DOT provider along with Community Facilitator of ACTB in Kulaura UHC for starting treatment. Dr. Jakir Hossain, MODC of Kulaura UHC, consulted with her and stated her treatment. As Mrs. Durgamoni Bawri was diagnosed as case of Bacteriologically Confirmed TB (693/21) according to National Guideline Mrs. Durgamoni Bawri started her medicine and felt some symptoms like weakness, joint pain and orange color urine in the first two months but after two months under consultation of MODC her health condition started to improve. Her DOT provider was very sincere and helped her to take medicine in every day. She regularly took medicine in six months but within this time she tested follow up sputum after two months, five months and six months later in Kulaura UHC and the final result was negative. Now she is fully cured and doesn’t feel any pain. She and her family members expressed deep satisfaction to USAID’s ACTB Project-HEED Bangladesh for identifying her as a TB patient and ensuring her treatment facilities.
Case Study: Mithun Vuiya
Mithun Vuiya (age 32), is a TB patient of Moulvi Tea Garden in Giasnagar of Moulvibazar has been suffering from cough, night fever, anorexia and gradual weight loss for the last five months. At first he went to local village doctors and did some tests and took some treatments. He was even admitted to Moulvibazar 250 Bed District Sadar Hospital but later went back to home without proper discharge. Despite taking treatments from different places his condition deteriorated day by day, he got bedridden and was unable to eat regular meals.
After spending about three months in this condition, as a part of regular household visits, Community Volunteer of USAID’s ACTB Project Mr. Laxmi Narayan Das (Munna) came across his house. The Community Volunteer observed his conditions & screened him along with his family members. Mr. Laxmi Narayan Das, Community Volunteer, selected him as a TB presumptive & provided him with a sputum pot instructing him to collect his early morning cough in it. After being tested in Gene Xpert he was diagnosed as a TB patient. Then Mr. Laxmi Narayan helped him to come to Moulvibazar Sadar UHC and helped him for his enrollment of TB treatment. Dr. Mahamuda Begum Sathi, Medical Ocer of Moulvibazar Sadar Upazilla Health Complex, started his TB treatment according to his weight. After taking 3 days of TB medicine the patient wanted to eat rice for the first time in 3 months. Then his appetite increased gradually and his condition started to improve slowly. As Mithun Vuiya was diagnosed as a case of Bacteriologically Confirmed TB (TR 455/22) according to National Guideline, contact tracing of his family members was done and following TPT guideline all the household members of patient house TPT treatment started through the consultation of medical officer of Moulvibazar Sadar UHC and Community Volunteer of USAID’s ACTB Project HEED Bangladesh provided all support including vehicle support for their TPT enrollment from Moulvibazar Sadar UHC.
TB patient Mithun Vuiya felt some symptoms like weakness, joint pain and orange color urine but his DOT provider is very sincere and helps him to take medicine every day. Community Volunteer of USAID’S ACTB Activity, HEED Bangladesh visited Mithun Vuiya regularly and followed up his improvement as well as he screened others members of Mithun’s family for TB symptoms. As Mithun has no ability to even stand on his own, so with the help of garden dresser Community Volunteer USAID’s ACTB Activity, HEED Bangladesh Mithun Vuiya’s 2nd month’s follow up sputum sample and weight was taken. His weight is only 28kg at that time.
Though the patient is improving, he is still unable to walk, stand or sit on his own. He is unable to move his hip and explained about his lower back pain. Medical officer, USAID’S ACTB project HEED Bangladesh examined the patient and found severe muscle wasting and decreased muscle power (3/5 in upper limbs and 2/5 in lower limbs) and suggested he needs more evaluation and supportive treatments if needed along with nutritional support.
Patient and his family members are having a very hard time both psychologically and financially. As the patient was the main earning member of his family and he gave full support to his family members but because of his sickness of the last five months his grocery shop is closed. His illness left a big impact on his family and the patient’s father said that he sold his two cattle to bear the daily expenses of his family. Mithun Vuiya has two school going children but he is not able to bear their education expenses at present. The patient’s family expects his quick recovery and hopes for more support for his betterment and further treatment. Patient Mr. Mithun Vuiya and his father Mr. Rajkumar Vuiya expressed their deep satisfaction to USAID’s ACTB Project HEED Bangladesh staff for all the support and care they received because they believe without those supports his son could have died.
