Moldova
Tuberculosis remains an increasing public health threat in Moldova. The country’s estimated TB incidence rate of 154 cases per 100,000 population is approximately 15 times higher than the incidence rates of Western European countries and one of the highest among the former Soviet Union countries. According to the World Health Organization’s Global Tuberculosis Control: WHO Report 2004, nearly 6,600 TB cases occurred in 2002, a 68 percent increase over 1999 and more than double the number of cases in 1990. The Ministry of Health estimates that a four fold increase in TB mortality has occurred over the last 10 years. The TB situation is particularly urgent in Moldova’s prison population, which has an incidence rate of approximately 6,000 cases per 100,000 population, almost 40 times the national average.
Moldova’s alarming TB indicators reflect the deterioration of the health care system since the breakup of the Soviet Union in the early 1990s. This breakup facilitated the spread of infectious diseases, including TB and multidrug-resistant TB (MDR-TB), in many former Soviet republics. Moldova was unable to sustain the previous TB infrastructure and needed new solutions to combat the growing TB problem. In 1996, the government designed its National Tuberculosis Program (NTP) and by 2001 had adopted the WHO-recommended Directly Observed Therapy, Short-Course (DOTS) strategy. Support from USAID and other donors is helping the NTP implement the DOTS strategy countrywide by 2005.
USAID Approach and Key Activities
USAID support for TB control in Moldova focuses on strengthening the health system’s capacity to implement the DOTS strategy by improving TB laboratories; enhancing diagnosis and treatment at the primary health care level and in prisons; increasing surveillance for TB and MDR-TB; and increasing public awareness of TB. Between 2002 and 2004, USAID funds for TB programming in Moldova averaged more than $1 million per year.
USAID-supported activities include the following:
- Renovating regional and national TB reference laboratories and training laboratory staff to enhance the country’s capacity to diagnose TB and MDR-TB
- Training more than 500 primary health care professionals and teams of primary health care doctors, nurses, and TB specialists to increase the capacity to diagnose and treat TB patients promptly at their first point of access to the health care system
- Designing and implementing an integrated electronic infectious disease surveillance system for TB, HIV/AIDS, and sexually transmitted infections to improve evidence-based decision making
- Developing and implementing a public education strategy to increase public awareness of TB symptoms and resources for diagnosis and treatment
- Addressing the need for adequate TB treatment for prisoners
- Developing a plan for TB drug management to ensure adequate and continuous drug supplies and procurement of low-cost TB drugs
USAID Program Achievements
USAID’s assistance and support have helped address TB prevention and control in Moldova through the following achievements:
- Developed a specialized TB hospital to care for prisoners with TB
- Developed and distributed TB press kits for World TB Day in February 2004
- Trained six trainers in TB diagnosis and treatment in primary health care settings and used these trainers in a first training session in September 2004
- Trained trainers in TB laboratory operations in September 2004
- Conducted a knowledge, attitudes, and practices survey in June 2004 to gather data for
developing a public education strategy
Case Detection and Treatment Success Rates Under DOTS
Partnerships
Partnerships are an important part of combating TB in Moldova. USAID’s TB partners in Moldova include the Moldovan government, the American International Health Alliance, Management Sciences for Health, the World Bank, the Swedish International Development Agency, and WHO. Moldova has received $11.7 million for HIV-TB activities in the first round of funding from the Global Fund to Fight AIDS, Tuberculosis and Malaria, and three awards from the Global Drug Facility for purchasing low-cost TB drugs.
December 2004
Related Links
|
