Our TB Shield model dramatically increases TB screening rates and preventive therapy uptake especially for children under 5
We launched the TB Shield model at one of the largest TB hospitals in Pakistan - the Federal Government TB Centre in Rawalpindi.
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Work on the ground is delivered by our partner Marie Adelaide Leprosy Centre working with the kind permission of the Pakistan Ministry of Health and National TB Program.
We ran a pilot from August to November 2024.
Before the pilot, TPT rates were very low and the hospital did not have have services for children. They wished to do more community outreach.
We designed a household screening and TPT program which involved:
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Launching a new household visit program
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Establishing an arrangement for referrals for paediatric services
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Providing capacity building for the hospital
The core of the TB shield model is home-based TB screening and TPT provision for under 5 year olds - facilitated by telemedicine.
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This means our team of Community Health Officers (CHOs) can screen children for symptoms of TB, get a prescription for TPT and deliver the first month of medicine all in one visit - making it as quick and easy as possible to reach these children.
For those over 5 years old, we provide enhance facility-based TB screening and TPT provision.
We support the hospital to provide counselling and improve tracking. Our team reach out via phone calls to provide household contacts with the information and encouragement necessary to visit the hospital and get screened for TB.
The results from our pilot demonstrate the success of this approach.
We worked with 167 people living with TB and their 950 household contacts. Even with low program costs, our program was able to achieve very high rates of TB screening and evaluation.
30%
Of household contacts of all ages were evaluated for TB.
87%
Of household contacts under 5 years old were evaluated for TB.
Uptake and completion TPT medicine was extremely high.
100%
93%
Uptake of TPT of those found eligible of all ages.
Average completion rate of TPT medicine for those who started Sep-Nov
We estimate that this program is highly cost-effective in line with some of the best global health programs.
MALC program team celebrating one year of delivering the program
