Improving the effectiveness of detection, treatment and prevention of tuberculosis in children in Nghe An

(Baonghean) - With the goal of reducing the incidence and mortality rate of tuberculosis in children in Nghe An, since March 2016, Nghe An Tuberculosis and Lung Disease Hospital has coordinated with PATH and Johnson & Johnson Vietnam to implement the project "Breath of Life". Up to now, the number of children detected with tuberculosis and INH prophylaxis in 4 districts of the project has increased 2-5 times; contributing to increasing the rate of detecting childhood tuberculosis and INH prophylaxis in the whole province.

Challenges in managing child labor

Currently, tuberculosis remains a burden and a global health emergency. Vietnam currently ranks 15th among 30 countries with the highest number of tuberculosis patients globally; statistics show that up to 90% of children with tuberculosis have not been detected.

Nghe An is one of the 10 provinces with the highest tuberculosis burden in the country. Every year, 2,700 - 2,900 new cases of tuberculosis are detected in the province. Of these, it is estimated that the number of children with tuberculosis accounts for about 10% of the total number of tuberculosis patients.

Examining a child patient at Nghe An Tuberculosis and Lung Disease Hospital. Photo: Dinh Nguyet

The National Tuberculosis Control Program has implemented activities to address childhood tuberculosis. However, detection, diagnosis and treatment still face many difficulties due to limited access to health care facilities for childhood tuberculosis. In Nghe An, management of childhood tuberculosis has been strengthened, but diagnosis, treatment and prevention still face many difficulties.

According to Dr. Dau Huy Hoan - Deputy Director of Nghe An Department of Health, currently, "The connection between the anti-tuberculosis program and public and private health facilities in managing tuberculosis in children is still limited. Diagnosis of tuberculosis in children is mainly performed at the Tuberculosis and Lung Disease Hospital. Cases of tuberculosis in children are often missed or not detected in health facilities outside the anti-tuberculosis program and at the grassroots level due to difficulty in diagnosis. The number of children exposed to the source of infection who receive INH prophylaxis is low due to the lack of systematic screening of children exposed to the source of infection in the community. Therefore, the implementation of the "Breath of Life" project has resolved the difficulties and limitations in managing tuberculosis in children, while improving the effectiveness of diagnosis, treatment and prevention of tuberculosis in children in Nghe An".

Increase the number of children detected and prevented from having TB by 2-5 times

The “Breath of Life” project was piloted in 4 districts: Dien Chau, Quynh Luu, Nam Dan and Yen Thanh. One of the districts with the highest number of TB patients in the province is Dien Chau.

Dr. Thai Van At - Former Deputy Director of Dien Chau District General Hospital said: Since the project was launched, the connection between the hospital, the Health Center and the Commune Health Station has been better. Training on diagnosis, treatment, prevention and management of tuberculosis in children in the community has been deployed from the district to the communes according to standard procedures. Thanks to that, grassroots health workers have performed well the tuberculosis screening process for children right at the local level.

Project staff supervise and support the screening of children exposed to the source of infection and administer INH prophylaxis in Dien Cat commune, Dien Chau. Photo: PV

Thanks to that, in Dien Chau in the past 18 months, the rate of detecting tuberculosis in children has increased significantly (2015: 26 children; 2016: 67 children and the first 9 months of the year: 36 children). The number of children receiving preventive treatment in the whole district has also increased, from 35 children in 2016, to 75 children in 2017.

Tuberculosis is an infectious disease, for children 0-5 years old who are in contact with pulmonary tuberculosis patients, participating in INH prophylaxis can reduce the risk of tuberculosis. “Breath of Life” plays an important role in raising people’s awareness of childhood tuberculosis and how to prevent this infectious disease.

Mrs. Nguyen Thi C's family (Hung Tien commune, Nam Dan district) has a relative with tuberculosis, her grandchild has been treated with INH preventive treatment according to the project "Breath of Life". Mrs. C said: "Since 2016, the commune health workers have come to examine, screen, and advise the family on TB preventive treatment for their 2-year-old child, and given instructions on taking medicine and hygiene to prevent the disease. Since then, my grandchild has been in good health and has gained weight normally, so the family is very assured about his health."

Doctor Dau Minh Quang - Director of Nghe An Tuberculosis and Lung Disease Hospital affirmed: The "Breath of Life" project contributed to detecting tuberculosis in children in 4 districts of the project. Photo: Dinh Nguyet

After 2 years of implementationi, the "Breath of Life" project has achieved its goals and had many positive impacts on child labor management in Nghe An.

Sharing about the project results, Dr. Dau Minh Quang - Director of the Provincial Tuberculosis and Lung Disease Hospital said: The project has helped improve the effectiveness of detecting, diagnosing and treating tuberculosis in children at the hospital and in the community. Early detection and good prevention will help manage tuberculosis in children more effectively and will contribute to reducing the burden of tuberculosis in adults. Thanks to the help of the Tuberculosis and Lung Disease Hospital Project, a pediatric department was established in March 2017, meeting the needs of examining and treating tuberculosis and lung diseases in children; creating a friendly play area for children, especially the training materials developed by the project are applied to the unit's continuing medical training program.

Commendation for units implementing the Breath of Life Project in Nghe An effectively. Photo: Dinh Nguyet

“Breath of Life” is a feasible and effective model in managing child labor in rural areas like Nghe An.

According to Dr. Kimberly Green - Director of the TB/HIV Program, PATH Organization, the success of the project in Nghe An shows the effectiveness of decentralizing the diagnosis of TB in children to the district level, mobilizing the participation of medical facilities outside the TB control network to coordinate with TB control facilities; systematically implementing the work of screening and managing children exposed to sources of infection; in early detection and prevention of TB in children. The experience of implementing the project in Nghe An will contribute significantly to improving the effectiveness of the project in Vietnam."

Discussing the plan to maintain and expand the project model in the province in the coming time, Dr. Dau Minh Quang - Director of the Tuberculosis and Lung Diseases Hospital added: "Nghe An continues to promote the results of the project, and at the same time continues to expand and deploy widely throughout the province; so that the work of preventing tuberculosis in children and tuberculosis prevention in general goes into depth and spreads."

Dinh Nguyet