Early detection, diagnosis, and treatment programs for tuberculosis, including latent tuberculosis – POCU 4.9

Project overview:

The project “Early Detection, Diagnosis, and Treatment Programs for Tuberculosis, Including Latent Tuberculosis” is being implemented by the “Marius Nasta” Institute of Pneumophthisiology in collaboration with the Romanian Angel Appeal organization. It aims to benefit communities in Dâmbovița County, targeting six communes where tuberculosis cases were identified in 2018.

Contract no.: POCU/225/4/9/117426 (SMIS Code 2014+: 117426)
Funding: Operational Program Human Capital
Priority Axis 4: Social Inclusion and Poverty Reduction
Thematic Objective 9: Promoting Social Inclusion, Combating Poverty, and Any Form of Discrimination
Investment Priority 9. iv: Increasing access to affordable, sustainable, and high-quality services, including healthcare and social services of general interest
Specific Objective 4.9: Increasing access to affordable, sustainable, and high-quality services, including healthcare and social services of general interest

Project purpose:

To promote social inclusion, combat poverty, and eliminate discrimination by enhancing access to affordable, sustainable, and high-quality services, including healthcare and social services. This is achieved through health programs and services aimed at the prevention, early detection (screening), diagnosis, and early treatment of tuberculosis, including latent tuberculosis, for 75,010 individuals from vulnerable groups.

Support activities:

• Assistance and subsidies for 15,003 individuals from vulnerable groups
• Information, education, and awareness activities for the target group
• Training programs for 560 professionals to improve their competencies in preventing, detecting (screening), diagnosing, and treating tuberculosis and latent tuberculosis

Long-term impact:

Most tuberculosis patients, including those with latent TB, are from low socio-economic backgrounds, living in poor, unsafe, or remote rural areas. The combination of TB and poverty often leads to:

• Isolation from family and friends
• Lack of information about available support and services
• Difficulty meeting basic needs and accessing healthcare
• Inability to afford food, medicine, or medical visits
• Job loss and debt
• Non-adherence to treatment and its interruption

Therefore, progress in controlling tuberculosis, including latent tuberculosis, in Romania and other parts of the European Economic Area requires investments in strengthening the main components of the national TB control program (diagnosis, treatment, and prevention) and addressing the social determinants of tuberculosis.

Early diagnosis and continuous treatment: Providing early diagnosis followed by uninterrupted, complete, and high-quality anti-TB treatment regimes, including Directly Observed Treatment (DOT) and incentives (financial, food) for patients, will lead to better treatment success rates among TB patients, allowing them to return to work and become productive citizens again.

Preventive interventions: Preventive interventions in poor rural communities will increase the accessibility of these populations to primary healthcare services, reduce the number of TB cases, lower stigmatization and discrimination of TB patients and their families, and improve the social and economic status of community members.

Specific objectives:

• Standardized national screening and control: Implement a unified national methodology for population screening using medical methods to detect the disease in its early stages.
• Training and capacity building: Improve theoretical and practical knowledge through support activities aimed at increasing the technical capacity of personnel involved in preventing, detecting, diagnosing, and treating TB and latent TB. This includes training programs for 560 individuals (social workers, community health workers, nurses, and health mediators) through accredited continuous medical education courses.
• Improving health status: Implement a comprehensive program for early detection (screening), diagnosis, and treatment of TB, including latent TB, for 75,010 individuals from vulnerable groups. This includes providing services and support to increase treatment adherence, including financial subsidies, peer-to-peer support, psychological counseling, and social assistance.
• Awareness and education: Promote the need for early detection, diagnosis, and treatment of TB, including latent TB, through targeted information, education, and awareness activities aimed at the target groups and the general public.
• Promoting social inclusion and reducing discrimination: Enhance access to durable, high-quality services through social innovation methods during training sessions and disseminate non-discrimination and equal opportunity principles to at least 560 professionals in the socio-medical sector.

Target group

The proposed project aims to provide essential health services focused on prevention, early detection (screening), diagnosis, and early treatment of tuberculosis, including latent tuberculosis. It targets 75,010 individuals from vulnerable groups who will benefit from support programs (screening) and 560 medical service providers (professionals involved in prevention, early detection (screening), diagnosis, and early treatment of tuberculosis, including latent tuberculosis) who will benefit from professional training programs.

Target group (TG) – vulnerable individuals:

• The target group will be located across all eight development regions, with the selection of all TG members made in compliance with the guide limits. Thus, 10% of the TG will come from Bucharest-Ilfov (BI), and 90% from the other seven less-developed regions.
• The selection of TG medical service providers will follow the same principle. The origin of the TG will be interpreted from the perspective of the members’ domicile address (vulnerable individuals).
• For TG members who do not have identification documents, self-declarations will be completed to show they live in the project implementation regions, i.e., all eight development regions. For the category of TG medical service providers, the origin of members will be established based on the location of the public institution where they work and with which they have a work contract.

Vulnerable situations of TG members:

• Homeless individuals
• Individuals suffering from alcohol, drug, and other toxic substance dependencies
• Rural residents (at least 45,000 individuals)
• Individuals deprived of liberty or under judicial control

Services provided

• Screening services: All 75,010 TG members will benefit from screening services (Activity 3.3), which will be carried out through mobile caravans to ensure easy access to these services for all TG members. 15,003 individuals will be referred to a specialist doctor (Activity 3.3) following screening investigations.
• Support services: Vulnerable individuals who participate in screening and are diagnosed with TB/TBL will benefit from support services (Activity 3.4), which will include assistance in managing their daily program, social and emotional support, and services that will facilitate, through the provision of information, access to medical care and resources available for the targeted area (TB).