Senegal
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Tuberculosis (TB) is a major public health problem in Senegal. According to the World
Health Organization (WHO) Global TB Report 2008, Senegal had more than 32,600
TB cases in 2006. Of these, 14,598 were sputum smear-positive (SS+) cases, with an
estimated incidence rate of 121 SS+ cases per 100,000 people. The incidence of TB
increased 2.1 percent between 2005 and 2006. The 2008 WHO Global TB Report did
not provide data on the DOTS (directly observed treatment, short course) case
detection or treatment success rate in Senegal. From 2002 to 2005, DOTS case
detection averaged 49 percent, while the DOTS treatment success rate increased from
53 to 74 percent between 2001 and 2004. There are limited data available on the
prevalence of HIV among TB patients, although 2003 data from hospitalized TB patients
in Dakar and Kaolack recorded HIV rates of 15 percent and 16 percent, respectively.
Overall HIV prevalence among new cases in 2006 was 2.7 percent. The prevalence of
multi-drug resistant (MDR) TB among new TB cases is just over 2 percent.
USAID’s Approach and Key Activities
USAID’s approach in Senegal complements the priorities of the National
Tuberculosis Control Program (NTP). Senegal is now operating under a new
strategic plan for TB for 2005 to 2009. The plan calls for improving the quality of
DOTS, decentralization of DOTS services, improving the management of MDR-TB
and TB-HIV/AIDS co-infection, and creating public-private partnerships to improve
case notification and cure rates. USAID’s approach is to improve TB treatment
success by targeting health facilities as well as communities where community
health workers will integrate community DOTS. In particular, this effort will target
Dakar, where 50 percent of Senegal’s TB burden is found. Between 2001 and
2007, USAID funds for TB programming in Senegal averaged approximately
$800,000 per year. USAID assistance targets the following activities and
interventions:
- Strengthening program management for TB at the national level
- Strengthening capacity for communities to correctly diagnose and treat TB
- Improving TB diagnosis (increased SS+ notification rate) in USAID-supported health facilities
- Improving follow-up for clinic-based TB treatment adherence in USAID-supported health facilities and decreasing treatment defaulter rates
- Decentralizing TB drugs to the health post level at three selected health posts per district
- Institutionalizing HIV/AIDS and TB reciprocal testing (i.e., HIV-positive patients are systematically screened for TB, and TB-positive patients are systematically offered voluntary counseling and testing services for HIV/AIDS)
- Supporting the national TB and HIV/AIDS programs to integrate TB-HIV/AIDS planning and monitoring at the operational levels
USAID Program Achievements
USAID’s support has reinforced NTP capacity to implement the DOTS strategy through the following achievements:
- Updated norms and protocols for TB case management, including HIV/TB co-infection
- Introduced a quality improvement approach for TB diagnosis
- Supported education sessions at the community level that led to increased community awareness of TB and reinforced the links between communities and their nearest TB diagnosis and treatment facilities.
- Trained 75 health care providers in 24 care units to implement the DOTS strategy
- Supervised health care units in 30 health districts in eight regions
- Provided basic TB information to 1,600 community leaders
- Created 94 support groups to reinforce the DOTS strategy at the community level
- Increased laboratory microscopy, resulting in 78 percent of USG-supported laboratories achieving 95 percent correctness, surpassing the target of 70 percent
Case Detection and Treatment Success Rates Under DOTS
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Note: DOTS treatment success rate for 2006 will be reported in the 2009 Global Report.
Source: Global Tuberculosis Control: Surveillance, planning, financing:WHO Report 2008. |
Partnerships
USAID works closely with the NTP and other international organizations including Family Health International, the Christian Children’s Fund, the International Union Against Tuberculosis and Lung Disease, and other U.S. private voluntary and nongovernmental organizations throughout the country. Senegal was approved for Round 7 grant of $3.9 million from the Global Fund to Fight AIDS, Malaria and TB.
February 2009
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