Tuberculosis

India_CHW_Photo__2006_Rose_Reis_Courtesy_of_Photoshare

Click the tabs to learn more about the Tuberculosis Working Group:

 

Vision:

The TB Working Group enhances NGO capacity to design and implement quality TB programs, with a focus on community-oriented programming.

Co-Chairs:

Gagik Karapetyan, World Vision

Devasena Gnanashanmugam, Independent

Petra Stankard, Population Services International

*CORE Group representatives on STOP TB's Advocacy, Communications and Social Mobilization activities/groups: Kayt Erdahl and Elena McEwan, Catholic Relief Services. Dr. McEwan also serves on the Civil Society GAVI Steering Committee

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About the TB Working Group

CORE Group’s TB Working Group maintains a consistent—some might say relentless—focus on community-based TB programming. Just a few years ago, TB control was typically managed by  “National Tuberculosis Programs” (NTPs), independent government entities, often separate from even the Ministry of Health. This top-down, biomedical model is evolving however, in response to the advent of HIV (TB being the biggest killer of people with HIV), the resulting resurgence of TB, the emergence of multi-drug resistant TB, and a growing understanding of the value of civil society involvement in health efforts.

Obviously, those already active in CORE Group's Community Health Network believe in the effectiveness and efficiency of social and community mobilization, behavior change communications, and patient-centered approaches. In the TB world, these kinds of ideas are often lumped together under the rubric of “Advocacy, Communications and Social Mobilization.” ACSM includes community-oriented efforts to educate the public, reduce stigma, identify likely cases of TB, minimize infection, refer suspects for diagnosis, deliver test results, and support curing of patients as they take medication on a daily basis for as long as several years—in close collaboration with government health systems.

As a relatively new set of activities within the TB world, many gaps exist in understanding how to best use community-level efforts to identify, cure and prevent TB. The data is even thinner with regards to TB and women, children and/or HIV-positive people, especially in low-income settings.

CORE Group’s TB Working Group is helping to identify and fill those gaps. We produce a range of resources, including community-based program design guidelines and case studies, and explore best practices in TB/HIV integration. Here’s a sampling of what we currently have in the works:

  • Supporting the development and dissemination of Advocacy, Communications, and Social Mobilization efforts within the STOP TB partnership
  • Advocating for better understanding of the value of community-based efforts
  • Promoting awareness, diagnosis and treatment of pediatric tuberculosis, and integration of maternal health and TB services.
  • Overseeing the update USAID’s Technical Reference Materials—a basic overview of TB control for NGOs interested in getting involved
  • Reviewing resources under development by the TB Coalition for Technical Assistance (TBCTA)
  • Growing our community-based TB listserv, with a focus on linking with field-based practitioners
  • Addressing other practical needs as they arise

Do any of these issues interest you? We welcome all to join our listserv, welcome suggested updates to this page and are interested in your opinions and ideas on community-based TB and TB/HIV efforts. Email Ann Hendrix-Jenkins at: ajenkins@coregroupdc.org

What's New in Community-Oriented TB Care?

In support of World TB Day 2012 spotlight on Pediatric TB, CORE Group’s Tuberculosis Working Group presented three webinars from world leaders in the fight against pediatric TB:

Tuberculosis that is “resistant to all drugs”
Global reporting on what is being called “totally drug resistant TB”  (TDR-TB) is causing alarm and confusion. WHO has provided guidance on their findings on this topic. For now, they do not recognize the  “TDR-TB.” Find out why, and what this means for TB control efforts worldwide.

Women and Tuberculosis: Taking Action Against a Neglected Disease
Tuberculosis is the third leading cause of death for women worldwide, according to the World Health Organization, but what can we do about it? Find out in this concise, current overview from Action/RESULTS.

Chehera: The human face of TB
This beautiful and moving series of artworks created by people with TB can be used to get attention, raise awareness, and generate dialogue.

Online Presentation: >Pediatric Tuberculosis: Missed Opportunities. A South African Perspective.

Presented by Dr. Anneke Hesseling, Professor and Director, Pediatric TB Research Program, Desmond Tutu Research Centre, Stellenbosch University, South Africa. June 8, 2011.

Dr. Hesseling shares her clinical expertise AND her practical programming experience in addressing pediatric TB is low resource settings. Despite the difficulties of diagnosing and treating pediatric TB, Dr. Hesseling makes the case that practical, effective approaches do exist, in accordance with guidelines from the World Health Organization. Dr. Hesseling maps out ways forward, which are urgently needed to address this huge, neglected problem.

Click on this link to watch a 45 minute long "rerun" of this presentation. (You'll need speakers to hear the audio portion. To view the slides only, click on this link.)

Online Presentation: Gene XPert. A groundbreaking new diagnostic technology for diagnosing TB:

Presented by Dr. Elizabeth Talbot, Associate Professor of Infectious Diseases and International Health at Dartmouth Hitchcock Medical Center, and Medical Scientist, FIND: Foundation for Innovative New Diagnostics. March 25, 2011.  

How might this new technology work in low and middle income countries? Where can it be used? Will it make a difference in the global effort to stop TB? Dr. Talbot provides context and an overview of the Xpert including its diagnostic capabilities, the technology behind it, how quickly a diagnosis can be made, what infrastructure and human resources are necessary, where WHO recommends its use, and the cost implications. 
View the 45 minute presentation by clicking on this link. (You'll need speakers to hear the audio portion. To view the slides only, click on this link.)

Stop TB PartnershipTB/HIV Working Group
Transforming the HIV/TB Response: Defining the next 10 years

The Stop TB Department of WHO, in collaboration with Georgetown University, organized a high level international consultation on behalf of the TB/HIV Working Group of the Stop TB Partnership, in conjunction with the AIDS 2012 conference in Washington DC on July 21, 2012. The aim of the meeting was to discuss innovative ideas and ways to define and shape the global TB/HIV response for the next decade. It also harvested experiences and identified key challenges and barriers in the scale-up of collaborative TB/HIV activities, including key research gaps.

CORE Group's Pediatric TB Page

Why aren't children with tuberculosis getting the attention and care they deserve? CORE Group’s TB Working Group has decided to focus special attention on this issue to accelerate community-based approaches to pediatric TB care and prevention.

WHO Reports Decline in TB, But Warms of Consequenses of Underfunding the Disease

October 2011 - The World Health Organization (WHO) reports for the first time that the number of people falling ill with tuberculosis (TB) each year is declining.  New data, published today in the WHO 2011 Global Tuberculosis Control Report, also show that the number of people dying from the disease fell to its lowest level in a decade. Yet, current progress is at risk from under-funding, especially efforts to combat drug-resistant TB.

Understanding and Challenging TB Stigma

"Written by and for trainers...planning and organising participatory educational sessions with community leaders or organised groups to raise awareness and promote practical action to challenge HIV and TB stigma and discrimination. Can be used alone or with accompanying HIV Stigma materials."  STAMPP, CREATE and International HIV/AIDS Alliance, 2009- See local organization project descriptions, posted below, March, 2011

Lessons Learned from TB Work with People Living with HIV. Includes descriptions of integrated interventions and good practice standards 

Improving Adherence to Treatment Patients not taking medicine is a chronic barrier to good health. How can we frame the issue and address it effectively? Presentation by Ira Wilson, Professor of Community Health, Brown U, January, 2011.

CORE Group's report out from the annual meeting of the International Union Against Tuberculosis and Lung Disease. Posted December, 2010. (Scroll down to Union Conference Reports.)

Tools, Presentations and Reports:

  • Community-based Tuberculosis Prevention and Care: A handbook for NGOs or CSO that are considering joining the fight against TB. 
  • Pediatric TB and HIV: The Potential of New TB Vaccinces (Elluminate recording - May 17, 2010) Presenter: Dr. Hoosein Coovadia, University of KwaZulu Natal, South Africa. World renowned TB expert Dr. Coovadia visited CORE Group's office to provide an overview of: the state of TB in the world, its links with HIV, effects on women and children, the potential for a TB vaccine, and progress being made towards vaccine solutions. Powerpoint Presentation
  • WHO Revised TB Treatment Guidelines: What's New? (Elluminate recording -  March 22, 2010) Presenter: Sarah Royce, MD, MPH, University of California, San Francisco Dr. Royce presents an overview of changes made to WHO's TB treatment guidelines, including drug regimens, sputum monitoring, and treatment guidelines for people with HIV and TB. Powerpoint presentation
  • Working Group Meeting: TB/HIV State of the Art Update - October 6, 2009
    CORE Group's TB and HIV Working Groups joined forces to convene this rich event. Click on the link above for an overview of the cutting edge questions, and presentations on scaling up, pediatric TB/HIV, partnering with communities, the role of malnutrition and more.
  • Improve Drug Treatment Adherence Through Patient Support (Elluminate recording - March 4, 2009)
    Presenter: Martha Benezet, MCDI
    Martha Benezet joined the session from South Africa to discuss MCDI's innovative and effective Facility-Patient Liaison program
  • Lessons Learned Exchange: TB Programming from the Community-Based Perspective - February 5 & 6, 2007
    Representatives from CORE Group,  CRS, PCI, DOW, Project HOPE, PSI, MCDI, WV, PATH, CARE, USAID, STOP TB, TBCAP, and the Open Society Institute met for two days to discuss this relatively new topic. Click on the link for the agenda, PowerPoint presentations and even poster competition award winners!

    Community-based TB case studies, project models, journal articles

     
    Case studies

    Local organization project descriptions
    • STOP TUBERCULOSE BOUAKÉ, working in Côte d’Ivoire, mobilizes communities and supports patients with TB and/or HIV, as described in their 2010 project report
    • Penduka is a local project, based in Namibia. Their project brochure provides a snapshot of their integrated, community-based project model. 2011.
    • MWASO is a local organization, based in Malawi. As you can see if their project achievements, they conduct a range of activities, including working with traditional healers, raising community awareness (see photos), community mobilization and creating sputum collection points. 2011.
    International organization project and portfolio descriptions Operations research findings

    Overviews of older USAID Grants CORE Group NGO member organizations are/have implemented--description, outcomes, constraints and lessons learned:

    Union Conference Reports

    CORE Group has regularly hosted a booth and participated in the annual meeting of The International Union Against Tuberculosis and Lung Disease. Reports from this meeting document the progress being made in this fast-moving field over the past several years.

      Global Stakeholders

      2012:

      • Supported the Pediatric TB Taskforce
      • WHO consultation on involvement of civil society organizations in TB
      • Hosted a Community TB booth at the IUATLD meeting.
      • Hosted a Webinar Series on TB:  Pediatric TB: The Basics;  Childhood TB: An MSF Field Perspective; and Tuberculosis Treatment: Successes and Challenges in the field: an overview from India of OperationASHA

      2011:

      • Supported pediatric TB
      • Provided WHO consultation on civil society involvement in TB

      2010:

      • Hosted a booth on community approaches at the IUATLD Meeting
      • Hosted a webinar series on TB Essential Drugs

      2009:

      • Collaborated with the HIV Working Group, resulting in a full day state-of-the-art TB/HIV seminar, with presentations and attendance of over 60 people representing dozens of NGOS, donors, and universities. More information. The Working Group also shared technical information from the field. Martha Benezet of MCDI  joined the CORE Community online from South Africa to discuss MCDI's innovative and effective Facility-Patient Liaison program. Watch her recorded presentation on the Challenge of Improving Drug Treatment Adherence Through Patient Support .
      • Hosted a booth at the annual Union Conference, to promote quality in community-based TB programming. The TB Working Group also hosted technical sessions at the CORE Group Spring and Fall Meetings, participated in other TB forums and events.

      2008:

       
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