Zimbabwe builds capacity to increase TB prevention coverage

Anotida Mubaira in Zimbabwe

TB (TB) prophylaxis (TPT) is a cost-effective way to reduce the risk of progression from TB infection to TB disease. TPT is a proven treatment that can prevent TB infection among people and has been shown to reduce TB-related mortality in people with HIV. TPT may reduce the risk of TB in family contacts of people with TB, people with HIV, and other high-risk groups with compromised immunity.

In addition, TPT can help people with HIV live longer, healthier lives. Zimbabwe’s TPT coverage has fallen from 39% in 2020 to 17% in 2021. This decline is the result of missed opportunities in TB contact tracing, which helps identify people at risk of TB infection in the community and get them into TPT quickly. Many people at risk of TB have missed the opportunity to receive TPT, making TB control difficult.

As part of the Government of Zimbabwe’s efforts to strengthen TB contact tracing and improve TPT coverage, the Ministry of Health and Child Welfare (MoHCC) adopted WHO operational guidelines and TB mobile app to support the adoption and expansion of TPT Services in Zimbabwe MoHCC, in collaboration with the World Health Organization, held an external review meeting on programmatic management of tuberculosis prophylaxis (TPT) in Zimbabwe from 5 to 8 July 2022.

Following the review, a report was issued and Zimbabwe developed an action plan to strengthen the implementation of TPT.

Enhanced contact tracing is one of the key interventions revealed in increasing TPT coverage. Now, the MoHCC has held a meeting in Mutare (July 25-29), 2022 on the adaptation of WHO’s TB prevention application. During this meeting, the MoHCC approved the WHO TB prevention application for use in Zimbabwe.

“Treating those with TB successfully and preventing other people from developing TB remains the most important intervention in ending TB in Zimbabwe,” says MoHCC, National TB/HIV Officer Dr Manners Ncube.

MoHCC, with the support of the Joint Hands Welfare Organization (JHWO), Union Zimbabwe Trust (UZT) and WHO, organized WHO training on TB prevention for pilot districts with high TB ​​prevalence, namely the districts of Gwanda and Isinza (Matabeleland province) and the district of Gweru, (Midlands Province) from November 28 to December 3, 2022. During the workshop, health workers from 3 pilot districts received training on how to use the WHO TB prevention app, including the development of an implementation and monitoring plan.

“The WHO Prevent TB Application mobile app allows registration, screening, and referral of people targeted for TB screening or TB preventive treatment. Alerts help the providers to follow up people through the preventive care pathway,” noted WHO Zimbabwe HIV and TB Technical Officer Dr Mkhokheli Ngwenya.

Traditionally, contact tracing for TB has been performed by an Environmental Health Technician (EHT). With the introduction of the WHO TB Prevention app and hybrid TB contact tracing, community nurses and village health workers will now be included. Which is an important milestone for Zimbabwe as there will be more people.

“The Prevent TB App is a game changer in our contact tracing. It will help us with contact tracing and increase TPT uptake. Moreover, the App will allow us to move away from the paper-based reporting system allowing efficient data analysis, provide us with real live data. Interventions will be more timeously as paper based reporting are done quarterly and it takes long for patients to be put on TPT,” added MoHCC, Senior Monitoring and Evaluation Officer, Mr Nicholas Siziba.

The Union Zimbabwe Trust Country Director, Dr Ronald Ncube highlighted how the implementation of combined TB contact tracing and the WHO TB application will significantly improve the link between TB patients and services. care, while minimizing cases lost during contact tracing.

“As UZT we remain committed to support the 8 districts including the 3 pilot districts which have poor TB outcomes through contact tracing and linking them to care on time, says Dr Ronald Ncube.