Senegal
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Tuberculosis (TB) is a major public health problem in Senegal. According to the World Health Organization’s (WHO’s) Global TB Report 2009, Senegal had more than an estimated 33,600 new TB cases in 2006. Of these, 14,706 were sputum smear-positive (SS+) cases, with an estimated incidence rate of 119 cases per 100,000 population. The incidence of TB increased 2.0 percent between 2006 and 2007. The DOTS (the internationally recommended strategy for TB control) case detection rate dropped slightly to 48 percent in 2007 since reaching 53 percent in 2003, while the DOTS treatment success rate increased from 70 to 76 percent between 2003 and 2006. There are limited data available on the prevalence of HIV among TB patients, although 2003 data from hospitalized TB patients in Dakar and Kaolack recorded HIV rates of 15 percent and 16 percent, respectively. Overall, HIV prevalence among new cases in 2007 was estimated at 12.5 percent. The prevalence of multidrug-resistant (MDR) TB among new TB cases is just over 2 percent.
USAID’s Approach and Key Activities
USAID’s approach in Senegal complements the priorities of the National Tuberculosis Control Program (NTCP). Senegal is now operating under a new strategic plan for TB for 2005–2009. The plan calls for improving the quality of DOTS, decentralizing DOTS services, improving the management of MDR-TB and TB-HIV/AIDS co-infection, and creating public-private partnerships to improve case notification and cure rates. USAID’s approach is to improve TB treatment success by targeting health facilities as well as communities where community health workers will integrate community DOTS. In particular, this effort will target Dakar, where 50 percent of Senegal’s TB burden is found. USAID funding for TB programming in Senegal was $843,000 in fiscal year 2008. USAID assistance targets the following activities and interventions:
- Strengthening program management for TB at the national level
- Strengthening capacity for communities to correctly diagnose and
treat TB
- Improving TB diagnosis (increased SS+ notification rate) in USAID-supported health facilities
- Improving follow-up for clinic-based TB treatment adherence in USAID-supported health facilities and decreasing treatment defaulter rates
- Decentralizing TB drugs to the health post level at three selected health posts per district
- Institutionalizing HIV/AIDS and TB reciprocal testing (i.e., HIV-positive patients are systematically screened for TB, and TB-positive patients are systematically offered voluntary counseling and testing services for HIV/AIDS)
- Supporting the national TB and HIV/AIDS programs to integrate
TB-HIV/AIDS planning and monitoring at the operational levels
USAID Program Achievements
USAID’s support has reinforced NTCP capacity to implement DOTS through the following achievements:
- Updated norms and protocols for TB case management, including HIV/AIDSTB co-infection
- Introduced a quality improvement approach for TB diagnosis
- Supported education sessions at the community level that led to increased community awareness of TB and reinforced
the links between communities and their nearest TB diagnosis and treatment facilities
- Trained 75 health care providers in 24 care units to implement DOTS
- Supervised health care units in 30 health districts in eight regions
- Provided basic TB information to 1,600 community leaders
- Created 94 support groups to reinforce DOTS at the community level
- Increased laboratory microscopy, resulting in 78 percent of U.S. Government-supported laboratories achieving 95 percent correctness, surpassing the target of 70 percent
Case Detection and Treatment Success Rates Under DOTS
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Note: DOTS treatment success rate for 2007 will be reported in the WHO Report 2010.
Source: Global Tuberculosis Control WHO Report 2009 |
Partnerships
USAID works closely with the NTCP and other international organizations, including Family Health International, the Christian Children’s Fund, the International Union Against Tuberculosis and Lung Disease, and other U.S. private voluntary and nongovernmental organizations throughout the country. Senegal was approved for a Round 7 grant of $3.9 million from the Global Fund to Fight AIDS, Tuberculosis and Malaria.
May 2009
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