1. Tuberculosis control in Suriname Situational analysis

2. Overarching goal To reduce incidence, mortality and transmission of Tuberculosis in Suriname. Strategic goals Detect 95% of expected sputum positive TB cases. Cure 95% of these cases

3. Objectives Implement and expand quality DOTS in Suriname Address TB/HIV, MDR-TB and the needs of vulnerable populations (TB/HIV collaborative activities, prevention and management of MDR-TB, treatment of Tb under DOTS in prisons) Contribute to health system strengthening Develop or Strengthen partnership to ensure equitable access to all TB patients Engage communities and affected people for ACSM

4. Current Situation Since May 2011 introduction of DOTS Sputum collection –Decentralized –NTP –Lung clinic Diagnosis –AZP: smear microscopy +PCR –SZN: smear microscopy –CL: smear microscopy+PCR+culture

5. Treatment Initiation by pulmonologist/internal medicine specialist (or other specialist in case EPTB) After 3 consecutive negative sputum discharge of patient and treatment follow up by NTP and Dot supporters

6. Trend 2000-2012 NTP database

7. Number of TB cases by age category NTP database

8. TB/HIV

9. Patient outcomes NTP database

10. Challenges Follow up treatment and diagnosis for (uninsured) foreigners Loss to follow up due to travel to home country Default due to travel to the interior (Gold miners)

11. Area of collaboration Collaboration between NTP’s regarding transfer of TB patient Exchange program to learn from each other expierience