TB REACH - Results
TB REACH Wave 1 Results
TB REACH collects case finding data quarterly from all of its grantees and has an independent agency that is tasked with monitoring and evaluating progress of all projects.
The final analysis shows that for the Wave 1 TB REACH projects, during project implementation, project areas delivered an average of 33% increase in case detection compared while some projects have seen increases of 60% to over 100%. In human terms, this translates into an additional 17,241 people with smear-positive TB that would otherwise have continued to infect others - many of whom would have died.
Cost: Throughout the duration of wave 1 projects (not including continuation funding), 28 projects have spent $16.3 million, with some reaching additional cases for as low as $70. These projects covered a population of about 89.2 million people. The average spent per capita of population covered per year is 0.18 USD.
TB REACH Wave 2 Results
The final analysis of wave 2 projects in their first year of implementation shows that after adjustment for pre-intervention trends, interventions found 25,811 additional bacteriologically positive cases of TB, reflecting an increase of 15% compared to the one-year historical baseline. Overall, 30,392 cases of all forms of tuberculosis were detected.
Wave 2 projects were implemented in 27 countries, and two-thirds of these projects used Xpert MTB/RIF technology to diagnose individuals for TB, showing a huge increase from wave 1. Many wave 2 projects were the first implementers in their country to use this technology.
|Bac+ cases notified at baseline||Bac+ cases notified at implementation||Additional cases adjusted by historical trends||Change from baseline|
|26 evaluation populations||81,794||91,408||11,945||15.1%|
|26 control populations||48,563||48,557||1,600||3.4%|
For 28 of 30 projects, the Xpert MTB/RIF assay was used as a follow on test after a negative smear microscopy result for most individuals with suspected TB. Therefore, any Xpert positive result should theoretically be considered as additional, as a smear negative result would have been led to a diagnosis of no TB in the absence of TB REACH. However, because many of these projects were the first implementers of Xpert in their country, it was often difficult to evaluate the impact of Xpert on notifications due to inconsistent reporting of results.
TB REACH Wave 3 Results
TB REACH is supporting 33 projects implementing Xpert MTB/RIF in 18 countries, many for the first time in the country. In total, TB REACH grantees have procured and placed almost 150 GeneXpert instruments into service and testing over 200,000 TB suspects in the coming months thanks in part to co-funding provided by the UNITAID TBXpert project. Projects have placed instruments in a variety of settings, including remote, rural areas, on mobile units, in private laboratories, reference laboratories and primary health facilities; and supplemented it by innovative case finding activities to improve access particularly to vulnerable and high risk population groups. Early results from the projects show a wide variety of experiences with the machine when put to use. In Tanzania the innovative approach of case finding along with the implementation of this new diagnostic test has helped increase TB case detection in the project area by 40% over the previous year. In Pakistan project areas in Karachi, TB positivity rates using Xpert MTB/RIF have been close to 20% even when testing among smear negative suspects. Procurement of equipment has been fast as a result of pooled procurement undertaken by the TB REACH Secretariat via the Global Drug Facility's mechanisms.