An overview on adherence to the use of a National TB screening tool to improve TB detection. BOT Hall, Dar es Salaam. October,2014. Increased Community Tuberculosis (TB) Detection Using National TB Screening Tool: Experience From Mzinga Military Hospital, Morogoro.

Presentation Lay Out: Introduction. Objectives. Methodology. Results. Lesson Learned. Recommendation. Acknowledgement.

1. Introduction: TB is among the top ten causes of morbidity and mortality in Tanzania (NTLP,2013). Access to TB screening at the community level remains a challenge. Mzinga Military Hospital (MMH) in Morogoro is one of the 64 TPDF health facilities, supported by PharmAccess and PEPFAR/US Department of Defense, to provide HIV/AIDS and TB services. At a world TB day in March,2014 the HCWs of MMH, conducted a 3 day TB screening outreach in households surrounding MMH and at Morogoro prison using National TB screening tool.

2.Objective To increase TB case detection. To increase community awareness on TB. To expand access of TB services to people around MMH.

3. Methodology TB screening was performed by HCWs, community health workers (CHWs) and expert patients (EPs) after an orientation training on the basics of TB. TST was translated into Kiswahili (photo1). Community radio and drama group were used for social mobilization. Photo1: Kiswahili TST

3. Methodology cont.. TST was administered to 234 people (75 inmates and 159 household members). Those 210 persons who answered YES to at least one of the 5 questions in the TST were sent to MMH for TB sputum microscopic examination (table 1 & Fig 1). Of 23 sputum samples from persons with high TB suspicion but with sputum microcopy negative at MMH were sent to SUA for APOPO and Gene Xpert testing

4. Results: Table1: Results of TB screening, March 2014, MMH: Total persons screened for TB Total # TB suspects #TB cases detected at MMH lab #TB cases detected by APOPO/Gene Xpert testing at SUA started TB Rx TB/HIV civiliansinmateciviliansinmatesciviliansinmatesciviliansinmates

5. Lessons learned: TST if adhered to and correctly used can increase TB case detection. CHWs and EPs can perform TB screening if trained and supervised. Many undetected infectious TB cases are still in the communities. TB screening outside of health facility will further increase TB case detection.

6. Recommendation: National TB screening tool to be translated into Kiswahili. Use the National TST beyond health facilities in combination with community education campaign on TB. Train CHWs and EPs on National TST for this purpose.

7. Acknowledgement: The work was done by TPDF HCWs, CHWs, EPs of Mzinga military hospital in collaboration with NTLP, NACP, Morogoro R/CHMT and SUA, APOPO project With funding from PEPFAR/DoD through PharmaAccess. THANKS FOR YOUR ATTENTION