The cumulative results for 2018 are shown as a percentage of the annual target. TB–HIV indicator (collaborative sites) and MDR-TB treatment indicators are funded by GFATM and other donors, while the others are funded by GFATM only.
TB grant implementation has also shown progress, with 7 out of 18 reportable indicators either meeting or exceeding the annual targets by the end of 2018.
During the year, 133,909 (84% of the annual target) TB patients were notified and enrolled on treatment. The treatment success rate was 87 per cent.
To increase case notification, coordination has been increased with other service providers such as military hospitals, public and private hospitals, and non-governmental organizations working in border areas with the involvement of ethnic minority health workers.
To increase identification of hidden TB cases, mobile active case finding activities have been expanded among groups including prisoners, industrial workers, miners, migrant workers and people who inject drugs.
External quality assurance samples (quality control slides) from 425 of the 450 participating laboratories were sent for assessment and 409 of the 425 laboratories, or 96 per cent, (94% of target) met the quality control performance criteria.
Training and mentoring of upper and lower Myanmar TB laboratories, technical assistance and supportive supervision from WHO were crucial in achieving this result. Refresher training and close supervision is usually provided to the low performance townships.
During the year, a total of 474 (66% of the target) children under the age of 5 years who were in contact with TB patients, began isoniazid preventive therapy (IPT). This reflects much improvement in screening and IPT provision in this age group.
A total of 1,006 (120% of target) of TB cases of all forms were notified among prisoners. Mobile active case finding activities are effective and can contribute to increasing TB case notification in prisons. During the year, 25,694 (98% of target) cases were notified among high-risk groups.
Some 66 per cent (83% of target) of TB patients with HIV infection had been enrolled on ART during TB treatment by the end of the year. The TB and HIV programmes continue to improve coordination and collaboration between the two programmes to maintain the good achievements on TB-HIV.
In 2018, 3,479 (71% of target) multi-drug resistant (MDR-TB) cases were notified. Advocacy meetings were held and refresher training conducted on the new algorithm of the TB treatment guidelines. As a result, the programme was able to identify more cases than in the previous year. During the year, 2,703 (69% of target) MDR-TB patients were put on second-line treatment.
The new MDR-TB guidelines have been implemented since the beginning of 2017, and training on the new algorithm of MDR-TB treatment conducted at the central and state/regional level, along with an increase in the number of GeneXpert sites to 75 in 2018. Workshops and review meetings were conducted on the strengthening of the sputum transportation system for implementing partners.
During the year, 10,627 (71% of target) of TB patients were referred and/or treated by partners implementing the public-private-mix (PPM) approach. The number of all forms of TB notified by community volunteers through community-based TB care activities, was 10,763 (72 % of target).
This year, 82,510, or 97 per cent (102% of target) of HIV patients were screened for TB during follow-up visits to the ART centre and decentralized sites.
Thirteen per cent (26%) of people living with HIV (PLHIV) newly enrolled in HIV care received isoniazid preventive therapy (IPT).
In 2018, only 49, or 2 per cent (120%) of MDR-TB patients who started treatment in the last 12 months, were lost to follow-up during the first 6 months of the treatment, much lower than the programmatic limit of 3 per cent.
In order to ensure MDR-TB treatment adherence, the grant provided nutritional support to all registered MDR-TB patients and routine health education messages are included on MDR-TB.
This year, 98 per cent (100%) of reporting units, which comprised 321 townships; 26 public hospitals; and 8 non-governmental organizations, submitted their reports (paper-based) in accordance with the national guidelines. The programme maintained its high performance, and robust recording and reporting system.
The HIV test results of 92 per cent (102% of the target) of notified TB cases were recorded in the TB register, exceeding the programmatic target of 90 per cent.
The drug sensitivity testing (DST) coverage was 48 per cent (80% of target), with nearly half of the registered TB patients tested.
GeneXPert testing is currently targeted to TB patients who are mainly from a high-risk group. The National TB Programme is striving to increase DST coverage through improved collaboration with the implementing partners.
In 2018, all reporting units reported no stockout of first-line anti-TB drugs.
