Tackling Ukraine’s Tuberculosis Crisis.

Odesa Oblast health care providers have struggled to initiate proper treatment of MDR-TB fast enough, particularly due to limited access to modern technology for quick detection. Low awareness of early TB symptoms among local health care providers compounded this problem and contributed to an average treatment delay of 125 days. Facing these obstacles to TB diagnosis, local health care providers and government officials looked to the USAID Strengthening Tuberculosis Control in Ukraine project, implemented by Chemonics, for support.

Together, these groups told us, we know what needs to be done: Our patients need better access to TB detection equipment so we can reach more of them faster. And medical professionals treating people with HIV need a more efficient referral system for TB diagnosis and treatment.

The project responded to this challenge by developing screening questionnaires for people living with HIV, ensuring that HIV patients will be referred more quickly for TB diagnosis and care. And crucially, the project provided better access to the state-of-the-art GeneXpert system and training.

The GeneXpert machine detects resistance to specific drugs used as a means of first-line treatment of TB. In a patient’s journey to TB diagnosis, health care providers play a vital role in sharing information, recognizing symptoms, conducting accurate tests for infection, and ultimately leading the patient to a full recovery. With easy-to-use screening questionnaires and sophisticated technology like the GeneXpert machine, health care providers are supported throughout the diagnosis process, particularly when they face complex cases such as MDR-TB.

“Before, we used less sensitive diagnostic techniques and often tuberculosis remained undiagnosed,” explains Dr. Svitlana Yesypenko, head of the Odesa Oblast TB/HIV aids facility. “Now one fourth of HIV-positive patients with MDR-TB are detected thanks to a new procedure. We would not have been able to detect their TB if we had used our previous approaches.”

Health care providers in the Odesa Oblast are now being trained to use the GeneXpert diagnostic technique. Laboratory staff in the region’s TB facilities are better able to detect MDR-TB cases and are using the internationally recognized standard diagnostic procedures to provide timely, and life-saving, early diagnoses to people living with HIV.

As the USAID Strengthening Tuberculosis Control in Ukraine project introduces easy-to-use referral mechanisms and provides sophisticated technologies in laboratory diagnostics and infection control, at-risk patients can foresee a path to a full recovery. The Odesa Oblast may face a difficult burden of active tuberculosis infections, but with the right combination of technology and patient-centered approaches, local communities and health care providers are in a stronger position to tackle TB.

“Our patients today are lucky, although most of them are not aware of this,” says Dr. Yesypenko. “They don’t know that diagnostic procedures that now only take 21 days would have taken them 125 days a year ago. More available GeneXpert diagnostics and proper referrals have resulted in a six-fold decrease in diagnostic time. For HIV-positive people with drug-resistant TB this difference often determines if they die or live.”