Neftaly MDR-TB Detection and Control Initiative

Goal: Raise the MDR-TB testing rate among re-treatment cases to at least 70%

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Background

Multi-Drug Resistant Tuberculosis (MDR-TB) poses a significant threat to public health, especially in areas with limited diagnostic capacity and weak treatment adherence. Individuals undergoing re-treatment for TB—those previously treated and now relapsing, failing, or returning after default—are at much higher risk of drug resistance. Prompt diagnosis is critical for effective treatment, infection control, and prevention of community spread.

Neftaly launched this initiative to strengthen early detection of MDR-TB by increasing the proportion of re-treatment TB cases who receive proper drug-resistance testing, aiming to reach at least 70% coverage.

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Strategic Objectives

1. Strengthen diagnostic infrastructure and referral systems
2. Increase awareness and provider accountability
3. Improve data reporting and monitoring systems
4. Ensure patient-centered support for testing adherence

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Key Activities and Interventions

1. Capacity Building and System Strengthening

• Collaborated with government and private labs to expand access to GeneXpert and culture/DST facilities.
• Supported the procurement and deployment of 4 additional GeneXpert machines in high-burden zones.
• Trained 150 healthcare providers on updated MDR-TB diagnostic protocols and re-treatment case management.

2. Provider Engagement and Case Monitoring

• Introduced mandatory MDR-TB screening protocols for all re-treatment TB cases in supported facilities.
• Developed a real-time electronic referral and tracking system to ensure samples are collected and tested promptly.
• Held regular facility-level review meetings to address gaps in re-treatment case testing.

3. Community Mobilization and Patient Education

• Created targeted awareness campaigns to inform patients of the importance of drug-resistance testing.
• Distributed “Know Your TB Status” patient booklets to re-treatment cases outlining their rights and care pathway.
• Integrated MDR-TB education into existing Neftaly community health worker visits.

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Results to Date

• MDR-TB testing among re-treatment cases increased from 42% to 68% over 12 months.
• 12,000+ re-treatment cases screened across 8 regions.
• Over 800 MDR-TB cases detected and linked to second-line treatment.
• Sample transportation delays reduced by 40% due to improved logistics coordination and regional partnerships.

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Challenges

• Limited availability of diagnostic tools in rural and conflict-affected areas.
• Turnaround time for lab results remains a barrier in some facilities.
• Initial provider resistance to updated guidelines required intensive mentoring and monitoring.

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Lessons Learned

• Routine mentoring and supportive supervision for healthcare workers significantly improve testing rates.
• Linking data systems between labs and treatment centers is critical for closing gaps in follow-up care.
• Community health workers play a vital role in patient tracking and adherence to testing protocols.

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Next Steps

• Achieve and sustain >70% MDR-TB testing rate across all Neftaly-supported health zones by the next review period.
• Expand testing coverage to include high-risk contacts and vulnerable populations, such as people living with HIV.
• Collaborate with the National TB Program to integrate universal DST (Drug Susceptibility Testing) for all TB patients.

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Conclusion

Neftaly remains committed to closing the diagnostic gap for MDR-TB. Through systems strengthening, provider training, and community engagement, we are moving closer to ensuring that every re-treatment TB patient receives timely, accurate testing and the care they deserve.