GHANA HEALTH SERVICE ASUOGYAMAN DISTRICT

Tuberculosis annual report

2009

Prepared and submitted by: DISEASE CONTROL UNIT FEBRUARY !"!

ASUOGYAMAN DISTRICT MAP

2009 ANNUAL TUBERCULOSIS CONTROL REPORT ASUOGYAMAN DISTRICT

1.0: INTRODUCTION 1.1 BACKGROUND INFORMATION Asuogyaman District is one of the twenty one districts in the Eastern region of Ghana. Until its creation, the area forms part of the former Kaoga District Council whose capital was Somanya. It co ers a total estimated surface area of !,"#$ s%uare &ilometers and constitutes ".$' of the total area of eastern region and ran&ing the !#th largest district in the region with its capital at Atimpo&u. (he District is )ordered to the *orth )y the Afram +lains District to the South )y *orth (ongu District ,est )y -anya Kro)o District, to the East )y South Dai District. 1.1.2 PHYSICAL CHARACTERISTICS (he topography of the District is generally undulating, with the following highlands . (ata)um, Kro)o Kyei /ulu, Adomi and Kpegyei. (he main water )odies include the 0olta 1i er and 2a&e, 1i er Ada)o, 1i er 3poto&u, the /aware, Anyinase 1i er and the /u)ua&an. Indeed it is on account of the fact the ma4or settlements are located on either side of the 0olta 2a&e that the name Asuogyaman was adopted for the District 56Asuogya7 . ,ater and 6man7 . state8. (he mean annual rainfall is a)out !!9#mm with a )imodal distri)ution and a ma:imum daily amount of a)out ;$mm. (he period -ay<=une constitutes the ma4or wet season, with the minor wet season occurring during the period Septem)er<*o em)er. Annual temperature is a)out >?C with a erage ma:imum and minimum )eing 9$C and !@C respecti ely. (he egetation of the District is a mi:ture of Aorest, Semi<AorestB1e<growth and Sa anna. 1.1.3 ECONOMIC ACTIVITIES Aarming constitutes the main economic acti ity of the ma4ority of the people, with maiCe, cassa a, and plantain )eing the ma4or crops. Aishing is also done mostly )y the /attors. /anana is grown for e:port as well as e:otic egeta)les 5e.g. green pepper8. (hese entures 5)anana and egeta)les8 are underta&en )y pri ate companies. -anufacturing, commercial and ser ice acti ities are also carried out mostly in A&osom)o, with the A&osom)o (e:tiles 2imited, 0olta Dotel, 0olta 1i er Authority and 0olta 2a&e (ransport Company 2imited )eing the main operati es. A&osom)o also houses the most ia)le mar&et in the District. (he Asuogyaman District has ast potentials for in estment particularly, in the area of tourism, agriculture and industry. 1.1.4 TOURISM The potentials include the following: /eautiful landscape and scenery along the 0olta 1i er and 2a&e. E:tensi e la&e shores for de elopment of )each resorts. 2

2009 ANNUAL TUBERCULOSIS CONTROL REPORT ASUOGYAMAN DISTRICT

Small islands located in the 0olta 2a&e especially in Atimpo&u. ,ater transport and ri er sport in the la&e.

1.1.5 AGRICULTURE The potentials are in the areas of: Suita)le soil and a)undant water for culti ation of e:otic egeta)les for )oth domestic consumption and e:port, and farming generally. Aish farming, oyster and lo)ster production. Conduci e egetation and a aila)le water for li estoc& farming on a large scale. E:istence of a 9<Star Dotel at A&osom)o and other motels at Atimpo&u. 1.1.6 INDUSTRY The District has comparative advantages for location of industry in the following ways: E:istence of inland port at A&osom)o, for ri er transport )etween the South and the *orth of the country. Easy access to power from A&osom)o and Kpong Dydro<Electric +ower +lant. +ro:imity to (ema, Accra and 2ome. 2arge deposits of clay for )ric& and tile industry. 2arge deposits of talc at Anum and /oso.

1.1. TRADITIONAL ADMINISTRATION (raditional Administration in Asuogyaman District is centered around chieftaincy as practiced )y its constituent ethnic groups . A&wamus, Anums and /osos. (he A&wamus are of A&an stoc& whilst the Anums and /osos are of the Guan stoc&. Each of the ethnic groups has a hierarchy of chiefs headed )y a paramount chief followed )y di isional chiefs, and illage chiefs. (hus the District has three (raditional Councils . A&wamu, Anum and /oso (raditional Councils, each headed )y the +aramount Chief and made up )y the Di isional chiefs. (he presence of significant Kro)o and Ewe settler groups ma&es the District greatly heterogeneous. D!"#$%&'() 1.1.* P#'+,&-.#/ S.0! &/1 G%#2-( R&-! (he District has )een demarcated into fi e 5"8 su)<districts and twenty one 5>>8 Community< )ased Dealth +lanning and Ser ices 5CD+S8 Cones with a)out !>@ communities. Currently, the population of the district is estimated to )e ?$,>EE.

2009 ANNUAL TUBERCULOSIS CONTROL REPORT ASUOGYAMAN DISTRICT

(he population of each facility catchments area is shown in ta)le ! )elow whilst that of the Su)< districts with their communities can )e found in ta)le >.

T&3,!1: P#'+,&-.#/ D.4-%.3+-.#/ 3) S+3 1.4-%.5-4

4!" POP 6% ANNUAL MONT&L' 59MNT& 90! TA#$ET 0% TA#$ET 0% +, *5" 11MONT& 11 MONT&S" (%L' TA#$ET 0 % 23! 11 TA#$ET MONT&S" WIFA

FA)ILIT' AKOSOMBO ATIMPOKU S.D.

ATIMPOKU NEW SENCHI SOUTH SENCHI SENCHI FERRY TORTIBO CHPS O ! AKRA!E CHPS

4 2% 0F *5 '#S ! OF TOTAL POPULATION POP 2010 POP. <15 20!

TT/E-PE)TE D P#E$ 4!

16

13,959

5,863

2,792

2,513

558

47

140

3,211

558

TOTAL ANUM/BOSO S.D. BOSO ANUM

!O!I ASANTEKOM CHPS

10.0 3.5 4.5 3.5 1.2 1.3 24

8,724 3,054 3,926 3,054 1,047 1,134 20,939

3,664 1,282 1,649 1,282 440 476 8,794

1,745 611 785 611 209 227 4,188

1,570 550 707 550 188 204 3,769

349 122 157 122 42 45 838

29 10 13 10 3 4 70

87 31 39 31 14 15 217

2,007 702 903 702 241 261 4,816

349 122 157 122 42 45 838

6.0 7.5 3.5 4.0 21

5,235 6,543 3,054 3,490 18,321

2,199 2,748 1,282 1,466 7,695

1,047 1,309 611 698 3,664

942 1,178 550 628 3,298

209 262 122 140 733

17 22 10 12 61

52 65 31 35 183

1,204 1,505 702 803 4,214

209 262 122 140 733

NEW !O!I CHPS TOTAL AKWAMUFIE S.D. AKWAMUFIE APE"USO FRANKA!UA MAN"OASE OSIABURA CHPS ANYANSU CHPS TOTAL ADJENA S.D. A!#ENA "YAKITI KU!I KOPE CHPS SE!OM CHPS SAPPOR CHPS TOTAL TOTAL

2.5 6.2 6.0 3.5 2.8 3.0 24

2,181 5,409 5,235 3,054 2,443 2,617 20,939

916 2,272 2,199 1,282 1,026 1,099 8,794

436 1,082 1,047 611 489 523 4,188

393 974 942 550 440 471 3,769

87 216 209 122 98 105 838

7 18 17 10 8 9 70

22 54 52 31 24 26 209

502 1,244 1,204 702 562 602 4,816

87 216 209 122 98 105 838

5.6 4.5 2.5 1.2 1.2 15 100

4,886 3,926 2,181 1,047 1,047 13,087 87,244

2,052 1,649 916 440 440 5,496 36,642

977 785 436 209 209 2,617 17,449

879 707 393 188 188 2,356 15,704

195 157 87 42 42 523 3,490

16 13 7 3 3 44 291

49 39 22 10 10 131 880

1,124 903 502 241 241 3,010 20,066

195 157 87 42 42 523 3,490

2009 ANNUAL TUBERCULOSIS CONTROL REPORT ASUOGYAMAN DISTRICT

T&3,! 2: P#'+,&-.#/ D.4-%.3+-.#/ 3) S+36D.4-%.5-4 &/1 -(!.% C#""+/.-.!47 2010 S+36D.4-%.5Atimpo&uBSenchi P#'+,&-.#/ 207:3: 8 P#'+,&-.#/ >E' >E' >!' !"' !;' 1008 N+"3!% #9 C#""+/.-.!4 >! >? !@ E@ !> 12:

A&wamufieBApeguso 207:3: AnumB/oso Ad4enaBGya&iti A&osom)o D.4-. T#-&, !?,9>! !9,#?$ !9,@"@ * 7244

1.*: H!&,-( C&%! (he health deli ery system in the district is carried out )y arious categories of health professionals wor&ing in twenty 5>#8 health facilities in the district. (he district has a total of two 5>8 hospitals 501A hospital and Asuogyaman District hospital8, se en 5$8 1CD centers, 9 Dealth centers, two 5>8 pri ate facilities, one 5!8 community clinic and four 5E8 functional CD+S centers. (he district has a total staff strength of two hundred and se enty nine 5>$@8, most of whom are concentrated at the 01A Dospital. (he district has forty si: 5E;8 outreach points where 1eproducti e and Child Dealth Ser ices are rendered. (he strongest strength of the district in terms of community health wor& is the Community<)ased Sur eillance programme. 3ne hundred and twenty 5!>#8 functional and acti e Community /ased Sur eillance 0olunteers 5C/S0s8 ha e )een trained to support community health acti ities. (hey record and report on epidemic<prone diseases, deli eries and deaths in their catchment areas on monthly )asis. Currently, the district is running the Community (/ Care programme with the support of the C/S0s. In addition to the C/S0Fs the district has fifteen 5!"8 trained (raditional /irth Attendants 5(/As8 augmenting the community health acti ities. (he district has a total of fi e 5"8 prayer camps andeighteen 5!?8 traditional her)alist centers.

2009 ANNUAL TUBERCULOSIS CONTROL REPORT ASUOGYAMAN DISTRICT

+oor accessi)ility to health facilities in terms of afforda)ility and transportation had )een a &ey pro)lem in the district for sometime past. Dowe er, with the implementation of the *ational Dealth Insurance Scheme, a)out ;9.9' of the residents access the health facilities without upfront payment. (he arious health facilities in the district and their respecti e locations are shown in ta)le 9. T&3,! 3: H!&,-( F&5.,.-.!4 &/1 -(!.% L#5&-.#/47 A4+#$)&"&/ F&5.,.-) Dospital Dealth Centre Community Clinic N#. > 9 ! L#5&-.#/ A&osom)o and Apeguso A&wamufie, /oso and Ad4ena Senchi Aerry Atimpo&u, *ew Senchi, South Senchi, Aran&adua, Gya&iti, *ew Senchi and A&osom)o com)ine Anum Kudi &ope, Sedorm, *ew Dodi, (orti)o and Ayensu

1eproducti e G Child Dealth " Centre +ri ate Clinic -ission Clinic CD+S Compounds SourceH DD-( . >#!# > ! E

(a)le !# )elow shows the main categories of health personnel a aila)le and their num)er in the district. T&3,! 4: H+"&/ R!4#+%5! P#4.-.#/ H!&,-( P!%4#//!, !. Doctor >. -edical Assistant 9. *urses at post E. +aramedical Staff N+"3!% ? 5$ at 01A and 3ne at DDA8 ! 5at 01A Dospital8 !9E 5$! at 01A hospital and ;9 for GDS8 9"

2009 ANNUAL TUBERCULOSIS CONTROL REPORT ASUOGYAMAN DISTRICT

2.0 INTRODUCTION (u)erculosis is a disease caused )y )acteria called Mycobacterium tuberculosis. -yco)acterium tu)erculosis which attac&s the lungs can also affect other parts of the )ody including )ones, 4oints and )rains. *ot e eryone who is infected with (u)erculosis )acteria de elops the disease. +eople who are infected 52atent (/8 donFt feel sic&, ha e no symptoms, canFt spread (/ to others, usually ha e a positi e s&in test reaction, chest :<ray and sputum tests normal, and can de elop (/ disease later in life. +eople who are infected )ut who do not de elop the disease do not spread the infection to others. (he immune system 6walls off7 tu)erculosis )acilli which, protected )y a thic& wa:y coat can lie dormant for years. Aor (/ infection to de elop into () disease the infected personFs immune system must )e wea&ened )y the following factors that are &nown to reduce resistanceH Ioung age, especially the first year of life +eople who are sic& with other diseases that wea&en the immune system -alnutrition Su) stance a)use Duman Immunodeficiency 5DI08 infection 3ccupation or en ironments that damage the lung 5mining, dust, smo&e8 3ther ris& factors include en ironmental factors e.g. 3 ercrowding +oor entilation +oor socio<economic status 3n a erage, each infecti e person will infect )etween !# and !" people each year. (u)erculosis is a disease which in ol es all organs of the )ody with the e:ception of hair, teeth and nails. It can )e di ided into +ulmonary 52ung8 and e:tra pulmonary forms. E:tra pulmonary tu)erculosis is much less common than pulmonary. It includes the spine 5)one8, s&in, lymph nodes, )rain and meninges, &idneys, intestine, etc. ETEOLOGICAL FACTORS IN THE SPREAD OF T.B IN GHANA (here are se eral factors influencing the spread of (/ in the Asuogyaman District, howe er the ma4or ones areH +o erty 2

2009 ANNUAL TUBERCULOSIS CONTROL REPORT ASUOGYAMAN DISTRICT

3 ercrowding Infection -alnutrition Ignorance Socio<economic factors

T.B. AND HIV;AIDS A significant cause of the dramatic rise in (/ cases from the mid <!@?#s onwards is the Duman Immunodeficiency irus. (oday tu)erculosis is the single )iggest &iller of people infected with DI0. DI0 infection considera)ly wea&ens a personFs immune system and ma&es them ulnera)le to other diseases. -yco)acterium tu)erculosis has a particularly synergistic dynamic with DI0, as DI0 accelerates, the progression of (/ infection to acti e (/ disease. +eople who are infected with (/ and DI0 are at least 9# times more li&ely to progress to acti e (/ disease than people with (/ infection alone. (he )urden of (/ greatly reduces the %uality of life of people who are DI0 positi e. If their (/ remains untreated, they ha e a high li&elihood of dying within a few months. (/ treatment for DI0 positi e patient is as effecti e as for those who are DI0 negati e, increasing the length and %uality of life of indi idual, and )enefiting their families and communities. In many African countries, more than half of (/ patients are also DI0 positi e. (here, (/ is percei ed as synonymous with AIDS. (u)erculosis is still a ma4or pu)lic health pro)lem and has )ecome more so since the post<DI0 era 5!@@> <>##>8, as DI0<+ositi e patients ha e a greater ris& of de eloping the disease. It is a leading cause of infectious illness and death worldwide. In Ghana it is estimated that )etween 9#' and "#' of all new (/ cases detected are infected with DI0 and E#' of all AIDS deaths are due to (/ glo)ally. (hose who are at high ris& of dying from (/ include people with DI0BAIDS, malnourished and other immuno<comprising condition, the ery young and the ery old. (he glo)al DI0 pandemic has )een a ma4or cause of increasing (/ cases, especially in Ghana. (he pre alence of DI0BAIDS is complicating (/ control, as many of the patients ha e dual infection. (he stop (/ strategy which is )eing implemented in Ghana consists of the followingH Digh %uality D3(S e:pansion and enhancement Address (/BDI0, multi<dose resistant (/ and other challenge Contri)ute to health system strengthen

2009 ANNUAL TUBERCULOSIS CONTROL REPORT ASUOGYAMAN DISTRICT

Engage all care gi ers Empower people with (/ and communities Ena)le and promote research.

DIRECTLY OBSERVED TREATMENT SHORT COURSE <DOTS= is a pro en system for (/ treatment, )ased on accurate diagnosis and patients ta&ing a full course of anti<(/ drugs which includes isoniaCid, rifampicin, pyraCinamide, streptomycin and etham)utol. D.%!5-,) O34!%>!1 T%!&-"!/- S(#%- C#+%4! <DOTS= is a strategy that pro ides the most effecti e medicine to (./ patients, ensures that they regularly ta&e these medicines as prescri)e and monitor their progress towards cure. D3(S is a way of helping patients ta&e their medicine for (/. If you get D3(, you will meet with a health wor&er e ery day or se eral times a wee&. Iou will meet at a place you )oth agree on. (his can )e the (/ clinic, your home or wor& or any other con enient location. Iou will ta&e your medicine at this place. (he D3(S strategy for (/ control consists of fi e 5"8 &ey elementsH Go ernment commitment to sustain (/ control Detection of infectious cases using sputum<smear microscopy StandardiCed, short course chemotherapy of si: to eight months, with direct o)ser ation treatment. A relia)le supply of high %uality drugs Information system for monitoring and reporting of treatment outcomes. (he D3(S strategy produces cure rates of up to @"', pre ents infections )y curing infectious patients and pre ents the de elopment of drug resistance. RATIONAL FOR DOTS D3(S lead toH Increase patient confidence and therefore more sic& people see& diagnosis

Increase patients adherence to treatment Cordial relationship )etween patients and health wor&ers thus impro ing the chances of cure and pre enting drug resistance. CONTACT TRACING !. Identify the inde: case, that is the patient with open sputum positi e disease >. In estigate other family mem)ers or contact of the patient 9. +ut on chemotherapy . all those found to )e positi e. EDUCATION

2009 ANNUAL TUBERCULOSIS CONTROL REPORT ASUOGYAMAN DISTRICT

(o ensure good compliance, the patient put on treatment should )e properly educated a)outH !. (he disease especially its natural history and e:pected response to effecti e chemotherapy. >. (he type of treatment, its effect on the disease, the side effect and how to manage them. B. PREVENTION !. Case finding >. ChemotherapyH encourage affected community to see& treatment 9. /CG accination of new)orns or at first contact E. Good nutrition< refrain from alcohol and smo&ing ". Impro ing socio<economic conditions ;. E%uita)le access to health ser ices $. 1aising of awareness ?. 1educing stigma @. Impro ing housing and nutritional status MULTI DRUG?RESISTANT TUBERCULOSIS <MOR ? TB= (his is defined as resistance to the two most important anti.(/ drugs, IsoniaCid and 1ifampicin, and it occurs whenH !. (he wrong treatment regimens 5dosages or com)ination of drugs8 are prescri)ed. >. (he right drugs are ta&en irregularly or not for long enough. ECONOMIC TOLL OF T.B (/ imposes a considera)le economic toll on patients and their familiesH a. Economic cost to patients ). Cost of pri ate Dealth Care c. In de)t for the future d. Costs to countries e. Emotional and social costs f. Discrimination CONTROL Impro ing li ing conditions of people Socio<economic conditions Acti e case identification ImmuniCation (reatment Dealth Education 2

2009 ANNUAL TUBERCULOSIS CONTROL REPORT ASUOGYAMAN DISTRICT

2.1 KEY PRIORITIES IN THE BEGINNING OF THE YEAR (he district (u)erculosis programme had the following outloo& for the year >##@H (o achie e case detection rate of $#' and curate 1ate of ?"'J /uild community pu)lic<pri ate partnership in case detection.

2.2 TUBERCULOSIS CONTROL ACTIVITIES During the period under re iew, the district carried out a series of tu)erculosis control acti ities under the Glo)al fund (/ programme. (he acti ities were in the area of the followingH 1e iew meetings -onitoring and Support isits. (raining of C/S0Fs and traditional healersBher)alist in =oint (/ and DI0 care and support in colla)oration with *G3 Drama *etwor&. ># health olunteers and ># religious leaders were trained in colla)oration with *G3, Drama networ&. Commemoration of ,orld (/ day at the su) district le els. Aifteen 5!"8 01A hospital staffs were trained in (/. 5ward nurses, la), dispensary, 3+D nurses, Doctors8 Ena)lers pac&age were pro ided to all (/ patients and C(/ pro iders 5 a total of E" patients and C(/ pro iders )enefited from the pac&age8. 2.3 LABORATORY @UALITY ASSURANCE K K !. >. 9. E. ". ;. K !. 9rd %uarter %uality assurance has )een done at 01A hospital )ut the Eth is yet to )e done due to the reno ation of the la)oratory 1esults of slide collection (otal num)er of slides e:amined was !9# (otal positi e slides ? (otal negati e !>> *um)er of slides sent for rechec&ing was !! +ositi e slides for rechec&ing was ! *egati e slides sent for rechec&ing was !# S(#%-9&,,4 &- -(! ,&3#%&-#%) <VRA= 1eporting and recording in the (/ register is complete 2

2009 ANNUAL TUBERCULOSIS CONTROL REPORT ASUOGYAMAN DISTRICT

>. (he hospital has no enough microscope for (/ e:amination 9. 3 er staining has made identification of slide num)ers difficult 2.4 REVIEA MEETINGS A series of re iew meetings were held during the period under re iew. (he o)4ecti es of the meetings wereH 1e iew the !st and >nd %uarter (/ acti ities in the district. +rogress made so far with regards to the district (/ care pathway. 1e iew of district sur eillance performance for the period Community )ased sur eillance olunteerFs acti ities in sur eillance and tu)erculosis. During the re iew meeting issues relating to case detection and confirmation, referral from the peripheral health facilities and (/ drugs were raised.

2.5 MONITORING AND SUPPORT VISITS (he following are reports of monitoring and supports isits carried out. (he !st and >nd Luarter (/ monitoring isits were made to access (/ acti ities at the facilities le els and how referred cases from other districts are )eing managedH (he o)4ecti es of the implementation wereH (o access the e:tent of the implementation of the district (/ care pathway which was de eloped )y the health staffs during the District training. (he following issues were loo&ed at during the support isitH (o access recording of cases in the suspected cases registers. (o identify the num)er of suspected cases and the num)er referred to the hospital for diagnosis. *um)er of cases on treatment regimenBnum)er which ha e completed treatment. A aila)ility of home erification forms. Correct use of treatment cards and treatment supportFs cards. (he following are some of the indicators used to access the facilitiesH Cases seen Education )eing carried out, Defaulters tracing )eing done, *um)er of *(+ Card and (/ registers in place. Drugs a aila)ility and smear positi e cases.

2.6 IMPACT INDICATORS

2009 ANNUAL TUBERCULOSIS CONTROL REPORT ASUOGYAMAN DISTRICT

(u)erculosis is a glo)al pandemic disease that has a lot of conse%uences, among them death especially if not seen and treated early among those who ha e de eloped the signs and symptoms. (his has called for the implementation of pragmatic measures )y all countries to help control the situation we encounter. All Districts in the country ha e not )een left out in (/ control implementation and in this light, the Asuogyaman District ha e implemented the following acti ities in the control of (/. (hese acti ities includeJ !. Luarterly training of "# C/S0s >. 3rganiCed dur)ars to sensitiCe community mem)ers and opinion leaders 9. School health is still undergoing to educate students on the essence of (/ control E. Dealth education is ongoing in churches, mos%ue, and &eep fit clu)s etc. to sensitiCe and educate mem)ers on the need for (/ control. ". Dealth staffs ha e )een trained in (/ management. ;. (/ screeningBeducation programmes carried out in colla)oration with an *G3 5Drama *etwor&8. (he ta)les and graphs )elow shows performance for the year >#!# 2. T+3!%5+,#4.4 C&4! D!-!5-.#/ (u)erculosis case detection in the district for the past years has )een low. (he district employed strategies such as community education, training, sensitiCation programmes, community in ol ement to help increase case detection rate. In >##@ the district had a target of detecting !#; smear positi e cases, howe er, only twenty four 5>E8 was detected for the year gi ing the case detection rate of >>' as against the regional target of ?#'. F.$+%! 1 T%!/1 #9 S"!&% P#4.-.>! T+3!%5+,#4.4 5&4!47 B&/6D!57 2004 ? 200:

2009 ANNUAL TUBERCULOSIS CONTROL REPORT ASUOGYAMAN DISTRICT

TREND OF REPOORTED S#EARPOSITI$E TBCASESIN T%E ASUO&YA#AN dISTRICT !!' ( !!)

#0

25

20

"5

T D S A C F O R E B # U N
"0 5 0 tb ca !

2004 "7

2005 7

2006 8

2007 27

2008 26

2009 22

A total of forty three 5E98 (/ cases were seen for year. All the cases are currently on treatment at the arious treatment sites in the district. F.$+%! 2 T%!/1 #9 T+3!%5+,#4.4 5&4!47 B&/6D!57 2006 ? 200:
T#END OF #EPO#TED TB )ASES 2006 % 2009, ASUO$'AMAN DIST#I)T
50 45 40 35

46 43

30
30 25

TB

E S A ) F . O N

20 15

10
10 5 0 TB

2006 10

2007 30 'EA#

2008 43

2009 46

(he highest num)er of cases seen for the period was recorded at A&wamufie, Apeguso and Anum Cones. During the half year all the (/ patients were gi en food supplements and treatment supporters also pro ided with ena)lers pac&age.
2009 ANNUAL TUBERCULOSIS CONTROL REPORT ASUOGYAMAN DISTRICT

(he ta)le )elow pro ides the analysis of (/ cases )y category of (/. T&3,! 5 T%!/1 #9 %!'#%-!1 TB 5&4!47 200* 6 200: YEAR N#. #9 5&4!4 4!!/ S"!&% P#4.-.>! 200* 200: 16 24 S"!&% N!$&-.>! 11 16 2 2 R!,&'4! EC-%& P+,"#/&%) T#-&,

2 4

43 46

(a)le ; pro ides analysis of (/ cases )y se:.

T&3,! 6 A/&,)4.4 #9 5&4!4 3) S!C ? 200: S"!&% S"!&% P#4.-.>! N!$&-.>! -A2E AE-A2E !$ $ @ $

R!,&'4! ! !

EC-%& P+,"#/&%) ! 9

T#-&, 2* 1*

2.* TB;HIV COLLABORATION (he ta)le )elow shows that out of E; (/ cases E> 5@!.9'8 were counseled for DI0 testing and 9@ 5@>.?'8 were tested. (en 5>".;'8 of the cases tested were positi e to DI0. (wo of them are currently on A1(. (he ta)le )elow shows the performance for the year >##? and >##@. T&3,! T%!/1 #9 TB;HIV 5#+/4!,./$ &/1 -!4-./$ %!4+,-47 200* 6 200: INDICATOR 200* 200: N+"3!% *um)er of cases *um)er counseled E9 9> 8 !@.$ $E N+"3!% E; E> 8 >!.! @!.9 2

2009 ANNUAL TUBERCULOSIS CONTROL REPORT ASUOGYAMAN DISTRICT

*um)er tested *um)er +ositi e *um)er on A1(

>? ; E

?? >! ;;

9@ !# >

@>.? >".; >#

Aigure 9H (rend of 1eported (/BDI0 cases, >##; . >##@, Asuogyaman District

TREND OF REPORTED TB* %I$ CASES+ ASUO&YA#AN DISTRICT !!, ( !!)
50

45

40

#5

#0

25

2006 2007

S A C F O R E B # U N

20

2008 2009

"5

"0

0 2006 2007 2008 2009

T$ta% ca ! "0 #0 4# 46

S&!a' P$ (t()! 8 2# 26 24

S&!a' N!*at()! 2 4 "2 "5

+I, P$ (t()! 0 8 6 "0

Table 8: T(%!! 6 Y!&% C#(#%- A/&,)4.4 C#"'&%!1 2006 ? 200* CASES E:pected *um)er of Cases to )e Detected 5All cases8 (otal *um)er of Cases Detected *ew Smear +ositi e Cases Smear *egati e Cured 2006 >9! 200 >9? 200* >E!

!# 5E.9'8 ? > $

9# 5!9'8 >9 $ >9

E9 5!?'8 >; !> >>

2009 ANNUAL TUBERCULOSIS CONTROL REPORT ASUOGYAMAN DISTRICT

(reatment completed Cured rate Success rate Defaulter rate Aailure rate Deaths rate

> $#' @#' # # #

$ !##' !##' # # > 5$'8

!> ?"' ?E' # # $ 5!;'8

3f the total forty one 5E!8 cases seen in >##?, si:ty three 5;9.E'8 were smear positi e, twenty nine percent 5>@'8 were smear negati e whilst the remaining eight percent 5?'8 were e:tra< pulmonary (/. (he cure rate among the smear positi e cases was ?"', treatment success was !##' whilst the death rate for all category was !$.#' (he Asuogyaman District has nine 5@8 facilities trained in DI0B(/ Counseling and (esting and among them includesJ !. Senchi Aerry Clinic >. Apeguso Clinic 9. Ad4ena Dealth Centre E. 01A Dospital ". Anum Sal ation Army ;. South Senchi 1CD $. Gya&iti 1CD ?. *ew Senchi 1CD @. /oso Dealth Centre 2a)oratory Luality Assurance 5LA8 is normally done at the 01A Dospital and for that, 9rd %uarter Luality Assurance has )een done )ut that of the Eth is yet to )e done due to the reno ation wor& at the la)oratory. (he results of the slide collection includeJ 2

2009 ANNUAL TUBERCULOSIS CONTROL REPORT ASUOGYAMAN DISTRICT

(otal *o. of slides e:amined M !9# (otal positi e slidesM? (otal negati eM !>> *um)er of slides sent for rechec&ing wasM !! +ositi e slides for rechec&ing wasM ! *egati e slides sent for rechec&ing wasM !#.

(he la)oratory at the 01A hospital has a num)er of shortfalls and they includeJ reporting and recording in the (/ register is incomplete, no enough microscope for (/ e:amination and it has )ecome difficult to identify slide num)ers due to o er staining.

(he District has a num)er of microscope Centres as shown in the ta)le )elowJ N#. #9 ".5%#45#'.5 5!/-!% F&5.,.-.!4 !&%"&%D!1 9#% ,&3 4!%>.5!4 N#. #9 9+/5-.#/&, ".5%#45#'.5 ./ 9&5.,.-.!4 > 501A Dospital and /oso Dealth Centre E 5S. Aerry, Anum Sal ation Army, Apeguso and Ad4ena Clinic > 501A Dospital and /oso Dealth Centre8

T&3,! :: N+"3!% #9 5&4!4 9%#" 200 6200: .4 4(#2/ ./ -(! -&3,! 3!,#2. YEAR N#. #9 4+4'!5-!1 TB 5&4!4 1!-!5-!1 N#. -!4-!1 ./ ,&3. N#. -!4-!1 '#4.-.>! !# !> >" 200 !#" !#" 200* !$; !$; 200: >!" >!"

Some of the inno ations that the District has underta&en includes, colla)oration with *G3s in training traditional leaders and community olunteers on (/, outreach programmes in churches and mos%ues 5supported )y *G38 on (/, reno ation of old mar&et stall at Senchi Aerry to pro ide la)oratory ser ices, and a research to conducted at Anum /oso Su) District to detect more cases

2009 ANNUAL TUBERCULOSIS CONTROL REPORT ASUOGYAMAN DISTRICT