Sekong: Tuberculosis Project

The Project

Tuberculosis remains a major public health problem in Laos. The poorest people, living in remote places and often suffering from malnutrition, are more often affected and most of them have limited access to screening and treatment. To address this problem, a national program tackling tuberculosis has been established based on the strategy "DOTS" developed by WHO. Its purpose is to significantly reduce mortality from the disease by giving everyone access to quality diagnosis and treatment.

Objectives:

SFE supports the implementation of the national fight against TB in the Sekong province, one of the poorest in the country, through a project that aims to:-

• Improve the detection of suspected cases
• Improve monitoring of patients
• Improve the quality of diagnosis

Activities

Activities have been developed to meet the objectives taking into account contextual issues (land, belief, educational level). In the Sekong province access to remote mountain village is very difficult and sometimes requires several days of walking. Access to remote hospitals and clinics in these mountain villages is also difficult and it is not surprising that villagers therefore only rarely visit the medical center.

Local people must be involved in this project to develop an awareness of this disease and improve screening.

SFE has established a multi-step training program for village health volunteers and those with responsibility in the villages. They learn to recognize the symptoms of the disease and then take charge of suspected cases by referring them to health centers for daily monitoring and also assure regular daily treatment. SFE mobile team goes in all areas of the province to conduct this training. The objective is to train health volunteers for all villages in the province. The mobile team uses this opportunity to conduct health education in villages so improving villagers’ awareness of this disease, its curability, and the means of prevention and treatment.

Improving diagnostic quality requires highly qualified medical staff. SFE organizes training sessions for staff in hospital laboratories to meet the technical needs. A pilot study was implemented to test the feasibility of blades diagnosis at clinics (nearer villages rather than hospitals) in order to increase quality. This requires special training for clinic staff. Training in radiology is also organized each year for physicians.

Goals indicators

• The impact of training in villages should result in an increase in the number of cases detected in areas where access is difficult.
• The pilot training of clinic staff should reveal whether this approach provides better quality blades for diagnosis.
• Technical training for laboratory personnel is expected to improve the quality of diagnostic slides. This improvement will be assessed during quality checks conducted by the National Center for Tuberculosis.