3. Aim: Contribute to NTPs aim of achieving case detection rate of 82% nationally Objectives: – To identify over 2 years an additional cases of MTB+ (3136) among slum, PLHA, prisoners, factory workers, refugees, household contacts of people living with TB and diabetics in Kathmandu Valley. – Ensure rapid diagnosis and treatment of all TB and MDR cases – To continually monitor and reflect on case finding and referral strategies Project Target Areas and Districts: 22 districts and 29 municipalities&cities (Kathmandu, Lalitpur, Bhaktapur, Kavre, Chitwan, Makwanpur, Parsa, Bara, Rautahat, Sarlahi, Mahottari, Dhanusha, Kaski, Rupandehi, Kapilbastu, Dang, Banke, Bardiya, Kailali, Accham, Doti and Kanchanpur)

4. TB REACH Projects in Nepal

5. Major Activities by Target Population: – Urban Slum: Door to Door Screening, Mobilization of urban health volunteers (UHV), Urban slum health camp, continual case finding activities – PLHA: Strong communication and coordination with VCT and ARV centres, distribution of TB/HIV IEC materials, Screening of PLHAs – Household Contacts: Identifying and recording and follow up of household contacts and screening and sputum collection – Prisoners: Screening and sputum collection – Factory Workers: Screening and sputum collection – Refugees, Monks and Nuns: Screening and sputum collection – Diabetics (In Kathmandu Valley Only): Coordination and communication with diabetic clinics, screening patients for symptoms and referring patients for microscopy

6. Strategies Mobilization of 34 outreach workers and 91 volunteers Coordination with local health institutions Coordination with respective target groups and populations Mobilization of van Conduction of microscopic camps Case finding and referral strategies

7. Screening Updates ( Mangsir to Falgun, 2070 ) TargetScreeni ng Sympto matics Microsc opic Tests Microsc opy Positive Total Gene Xpert Tests GX+ve cases Total Bacterio logical Positive Slum27,9101,4661,177196041837 PLHIV263113 09014 HH Contact s 7462632551444620 Prisone rs 31218918527013 Factory Workers 3,125419361028333 Refugee s/Mona steries 1,272349329119134 Diabeti cs 0000000 TOTAL33,6282,7992,420361,2824581

8. Gene xpert result ( Mangsir to Falgun, 2070 ) SNSN Expert CenterMTB ND MTB +/RIF ”S” MTB + / RIF “R” MTB +/ RIF “I” ERRO R INVALI D NO RESULT TOTA L 1DHO Doti53182092286 2DPHO Chitwan 352430181081 3Van One439194028210511 4Van Two404141167120499 5HERD Thapathali 2110062030 6Manohara75200110189 Total1027781011393831296

9. Gene xpert result ( Mangsir to Falgun, 2070 )

10. TB Reach Project in Nepal Summary sheet of MTB cartridges Use and Demand- to be monthly updated by all TBREACH partners operating Xpert technology SNXpert site A) No.cartridges in stock at start of period No. cartridges received during the period No.cartridges used Remaining cartridges (D - H) Exp. date B) from HQs C) from other units D) Total (A+B +C) E) UsedF) ExpiredG) Transfer out H) Total (E+F+G) 1DHO Doti200120032013000 19006.07.2014 2DPHO Chitwan120 02409500 145,, 3Manohara CHC604001009000 10,, 4Van One180360054051900 21 5Van Two180420060052900 71 6HERD Lab0400 3000 10 Balance of cartridges at HERD sites740110001840139300 447 Balance of cartridges at HERD store3200 1020

11. World TB Day 2014