Asuogyaman Tb 2009

8/13/2019 Asuogyaman Tb 2009

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GHANA HEALTH SERVICEASUOGYAMAN DISTRICT

Tuberculosis annual report 2 9

Prepared and submitted by:

DISEASE CONTROL UNIT

FEBRUARY !"!


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ASUOGYAMAN DISTRICT MAP

2009 ANNUAL TUBERCULOSIS CONTROL REPORT ASUOGYAMAN DISTRICT


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1.0: INTRODUCTION

1.1 BACKGROUND INFORMATION

Asuogyaman District is one of the twenty one districts in the Eastern region of Ghana. Until itscreation, the area forms part of the former Kaoga District Council whose capital was Somanya. It

coers a total estimated surface area of !,"#$ s%uare &ilometers and constitutes ".$' of the total

area of eastern region and ran&ing the !#thlargest 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 1ier and 2a&e,

1ier Ada)o, 1ier 3poto&u, the /aware, Anyinase 1ier 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


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Small islands located in the 0olta 2a&e especially in Atimpo&u.

ater transport and rier sport in the la&e.

1.1.5 AGRICULTURE

The potentials are in the areas of:

Suita)le soil and a)undant water for cultiation of e:otic egeta)les for )oth domestic

consumption and e:port, and farming generally.

ish farming, oyster and lo)ster production.

Conducie egetation and aaila)le water for liestoc& farming on a large scale.

E:istence of a 98 Community@ communities.

Currently, the population of the district is estimated to )e ?$,>.



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(he population of each facility catchments area is shown in ta)le ! )elow whilst that of the Su).

T&,!1: P#'+,&-#/ D-%+-#/ ) S+ -%-

AKOSOMBO 16 13,959 5,863 2,792 2,513 558 47 140 3,211 558

ATIMPOKU S.D.

ATIMPOKU 10.0 8,724 3,664 1,745 1,570 349 29 87 2,007 349

NEW SENCHI 3.5 3,054 1,282 611 550 122 10 31 702 122

SOUTH SENCHI 4.5 3,926 1,649 785 707 157 13 39 903 157

SENCHI FERRY 3.5 3,054 1,282 611 550 122 10 31 702 122

TORTIBO CHPS 1.2 1,047 440 209 188 42 3 14 241 42O! AKRA!E CHPS 1.3 1,134 476 227 204 45 4 15 261 45

TOTAL 24 20,939 8,794 4,188 3,769 838 70 217 4,816 838

ANUM/BOSO S.D.

BOSO 6.0 5,235 2,199 1,047 942 209 17 52 1,204 209

ANUM 7.5 6,543 2,748 1,309 1,178 262 22 65 1,505 262

!O!I ASANTEKOM CHPS 3.5 3,054 1,282 611 550 122 10 31 702 122

NEW !O!I CHPS 4.0 3,490 1,466 698 628 140 12 35 803 140

TOTAL 21 18,321 7,695 3,664 3,298 733 61 183 4,214 733

AKWAMUFIE S.D.

AKWAMUFIE 2.5 2,181 916 436 393 87 7 22 502 87

APE"USO 6.2 5,409 2,272 1,082 974 216 18 54 1,244 216

FRANKA!UA 6.0 5,235 2,199 1,047 942 209 17 52 1,204 209

MAN"OASE 3.5 3,054 1,282 611 550 122 10 31 702 122

OSIABURA CHPS 2.8 2,443 1,026 489 440 98 8 24 562 98

ANYANSU CHPS 3.0 2,617 1,099 523 471 105 9 26 602 105

TOTAL 24 20,939 8,794 4,188 3,769 838 70 209 4,816 838

ADJENA S.D.

A!#ENA 5.6 4,886 2,052 977 879 195 16 49 1,124 195

"YAKITI 4.5 3,926 1,649 785 707 157 13 39 903 157

KU!I KOPE CHPS 2.5 2,181 916 436 393 87 7 22 502 87

SE!OM CHPS 1.2 1,047 440 209 188 42 3 10 241 42

SAPPOR CHPS 1.2 1,047 440 209 188 42 3 10 241 42

TOTAL 15 13,087 5,496 2,617 2,356 523 44 131 3,010 523

TOTAL 100 87,244 36,642 17,449 15,704 3,490 291 880 20,066 3,490

4!"

ANNUAL

TA#$ET 0%

11MONT&

MONT&L'

TA#$ET 0%

11 MONT&S"

(%L'

TA#$ET 0 %

11

MONT&S"FA)ILIT'! OF TOTAL

POPULATION POP 2010

*5 '#S

20!

POP 6%

59MNT& 90!

+ *5"

23!

TA#$ET

WIFA

TT/E-PE)TE

D P#E$ 4!

42% 0F

POP.


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T&,! 2: P#'+,&-#/ D-%+-#/ ) S+D-%- &/ -(!% C#""+/-!7 2010

S+D-%- P#'+,&-#/ 8 P#'+,&-#/

N+"!% #9

C#""+/-!

Atimpo&uBSenchi 2073 >' >!

A&wamufieBApeguso 2073 >' >?

AnumB/oso !?,9>! >!' !@

Ad4enaBGya&iti !9,#?$ !"' @

A&osom)o !9,@"@ !;' !>

D-. T#-&, *7244 1008 12

1.*: H!&,-( C&%!

(he health deliery 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, seen 5$8 1C centers, 9 ealth

centers, two 5>8 priate facilities, one 5!8 community clinic and four 58 functional C+S

centers. (he district has a total staff strength of two hundred and seenty nine 5>$@8, most ofwhom are concentrated at the 01A ospital.

(he district has forty si: 5;8 outreach points where 1eproductie and Child ealth Serices are

rendered.

(he strongest strength of the district in terms of community health wor& is the Community#8 functional and actie Community /ased

Sureillance 0olunteers 5C/S0s8 hae )een trained to support community health actiities.

(hey record and report on epidemic


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+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. oweer, with the implementation of the *ational

ealth 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 respectie locations are shown in ta)le 9.

T&,! 3: H!&,-( F&,-! &/ -(!% L#&-#/7 A+#$)&"&/

F&,-) N#. L#&-#/

ospital > A&osom)o and Apeguso

ealth Centre 9 A&wamufie, /oso and Ad4ena

Community Clinic ! Senchi erry

1eproductie Child ealthCentre

" Atimpo&u, *ew Senchi, South Senchi,ran&adua, Gya&iti,

+riate Clinic > *ew Senchi and A&osom)o com)ine

-ission Clinic ! Anum

C+S Compounds Kudi &ope, Sedorm, *ew Dodi, (orti)o and

Ayensu

SourceH D-( >#!#

(a)le !# )elow shows the main categories of health personnel aaila)le and their num)er in the

district.

T&,! 4: H+"&/ R!#+%! P#-#/

H!&,-( P!%#//!, N+"!%

!. Doctor ? 5$ at 01A and 3ne at DA8

>. -edical Assistant ! 5at 01A ospital8

9. *urses at post !9 5$! at 01A hospital and ;9 for GS8

. +aramedical Staff 9"



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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 eeryone who is infected with (u)erculosis )acteria deelops the disease. +eople who are

infected 52atent (/8 donFt feel sic&, hae no symptoms, canFt spread (/ to others, usually hae

a positie s&in test reaction, chest :


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3ercrowding

Infection

-alnutrition

Ignorance

SocioImmunodeficiency irus. (oday tu)erculosis is the single )iggest &iller of people infected with

I0. I0 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 I0, as I0 accelerates, the progression of (/ infection to actie (/ disease. +eople who

are infected with (/ and I0 are at least 9# times more li&ely to progress to actie (/ diseasethan people with (/ infection alone. (he )urden of (/ greatly reduces the %uality of life of

people who are I0 positie. If their (/ remains untreated, they hae a high li&elihood of dying

within a few months.

(/ treatment for I0 positie patient is as effectie as for those who are I0 negatie,

increasing the length and %uality of life of indiidual, and )enefiting their families and

communities. In many African countries, more than half of (/ patients are also I0 positie.

(here, (/ is perceied as synonymous with AIDS.

(u)erculosis is still a ma4or pu)lic health pro)lem and has )ecome more so since the post ##>8, as I0


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Engage all care giers

Empower people with (/ and communities

Ena)le and promote research.

DIRECTLY OBSERVED TREATMENT SHORT COURSE


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(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 effectie

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

. Good nutrition< refrain from alcohol and smo&ing

". Improing socio


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2.1 KEY PRIORITIES IN THE BEGINNING OF THE YEAR

(he district (u)erculosis programme had the following outloo& for the year >##@H

(o achiee case detection rate of $#' and curate 1ate of ?"'J

/uild community pu)lic# health olunteers and ># religious leaders were trained in colla)oration with*G3, Drama networ&.

Commemoration of orld (/ day at the su) district leels.

ifteen 5!"8 01A hospital staffs were trained in (/. 5ward nurses, la),dispensary, 3+D nurses, Doctors8

Ena)lers pac&age were proided to all (/ patients and C(/ proiders 5 a total of

" patients and C(/ proiders )enefited from the pac&age8.

2.3 LABORATORY @UALITY ASSURANCE

9rd%uarter %uality assurance has )een done at 01A hospital )ut the this yet to )e done

due to the renoation of the la)oratory

1esults of slide collection

!. (otal num)er of slides e:amined was !9#>. (otal positie slides ?

9. (otal negatie !>>

. *um)er of slides sent for rechec&ing was !!". +ositie slides for rechec&ing was !

;. *egatie slides sent for rechec&ing was !#

S(#%-9&,, &- -(! ,%&-#%)


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>. (he hospital has no enough microscope for (/ e:amination

9. 3er staining has made identification of slide num)ers difficult

2.4 REVIE MEETINGS

A series of reiew meetings were held during the period under reiew. (he o)4ecties of the

meetings wereH

1eiew the !stand >nd%uarter (/ actiities in the district.

+rogress made so far with regards to the district (/ care pathway.

1eiew of district sureillance performance for the period

Community )ased sureillance olunteerFs actiities in sureillance and tu)erculosis.

During the reiew 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 !stand >ndLuarter (/ monitoring isits were made to access (/ actiities at the facilities

leels and how referred cases from other districts are )eing managedH

(he o)4ecties of the implementation wereH

(o access the e:tent of the implementation of the district (/ care pathway which was

deeloped )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 fordiagnosis.

*um)er of cases on treatment regimenBnum)er which hae completed treatment.

Aaila)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 aaila)ility and smear positie cases.

2.6 IMPACT INDICATORS



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(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 hae deeloped 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 hae not )een left out in (/ control implementation and in this light,the Asuogyaman District hae implemented the following actiities in the control of (/. (hese

actiities includeJ

!. Luarterly training of "# C/S0s

>. 3rganied dur)ars to sensitie community mem)ers and opinion leaders

9. School health is still undergoing to educate students on the essence of (/ control

. ealth education is ongoing in churches, mos%ue, and &eep fit clu)s etc. to sensitie and

educate mem)ers on the need for (/ control.

". ealth staffs hae )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+!%+,# C&! D!-!-#/

(u)erculosis case detection in the district for the past years has )een low. (he district employed

strategies such as community education, training, sensitiation programmes, community

inolement to help increase case detection rate.

In >##@ the district had a target of detecting !#; smear positie cases, howeer, only twenty four

5>8 was detected for the year giing the case detection rate of >>' as against the regional target

of ?#'.

F$+%! 1 T%!/ #9 S"!&% P#->! T+!%+,# &!7 &/D!7 2004 ? 200



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2004 2005 2006 2007 2008 2009

tb ca! "7 7 8 27 26 22

0

5

"0

"5

20

25

#0

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

A total of forty three 598 (/ cases were seen for year. All the cases are currently on treatment at

the arious treatment sites in the district.

F$+%! 2 T%!/ #9 T+!%+,# &!7 &/D!7 2006 ? 200

2006 2007 2008 2009

TB 10 30 43 46

10

30

43

46

0

5

10

15

20

25

30

35

40

45

50

NO.OF)ASES

'EA#

T#END OF #EPO#TED TB )ASES 2006 % 2009, ASUO$'AMAN DIST#I)T

TB

(he highest num)er of cases seen for the period was recorded at A&wamufie, Apeguso and

Anum ones. During the half year all the (/ patients were gien food supplements and treatment

supporters also proided with ena)lers pac&age.



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(he ta)le )elow proides the analysis of (/ cases )y category of (/.

T&,! 5 T%!/ #9 %!'#%-! TB &!7 200* 200

YEAR N#. #9 &! !!/ R!,&'! E-%&

P+,"#/&%)

T#-&,

S"!&%

P#->!

S"!&%

N!$&->!

200* 16 11 2 2 43

200 24 16 2 4 46

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

T&,! 6 A/&,) #9 &! ) S! ? 200

S"!&%

P#->!

S"!&%

N!$&->!

R!,&'! E-%&

P+,"#/&%)

T#-&,

-A2E !$ @ ! ! 2*

E-A2E $ $ ! 9 1*

2.* TB;HIV COLLABORATION

(he ta)le )elow shows that out of ; (/ cases > 5@!.9'8 were counseled for I0 testing and

9@ 5@>.?'8 were tested. (en 5>".;'8 of the cases tested were positie to I0. (wo of them are

currently on A1(.

(he ta)le )elow shows the performance for the year >##? and >##@.

T&,! T%!/ #9 TB;HIV #+/!,/$ &/ -!-/$ %!+,-7 200* 200INDICATOR 200* 200

N+"!% 8 N+"!% 8

*um)er of cases 9 !@.$ ; >!.!

*um)er counseled 9> $ > @!.9



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*um)er tested >? ?? 9@ @>.?

*um)er +ositie ; >! !# >".;

*um)er on A1( ;; > >#

igure 9H (rend of 1eported (/BI0 cases, >##; >##@, Asuogyaman District

T$ta% ca! S&!a' P$(t()! S&!a' N!*at()! +I, P$(t()!

2006 "0 8 2 0

2007 #0 2# 4 8

2008 4# 26 "2 6

2009 46 24 "5 "0

0

5

"0

"5

20

25

#0

#5

40

45

50

NU#BEROFCASESSEEN

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

2006

2007

2008

2009

Table 8: T(%!! Y!&% C#(#%- A/&,) C#"'&%! 2006 ? 200*

CASES 2006 200 200*

E:pected *um)er of Cases to )e Detected 5All

cases8

>9! >9? >!

(otal *um)er of Cases Detected !# 5.9'8 9# 5!9'8 9 5!?'8

*ew Smear +ositie Cases ? >9 >;

Smear *egatie > $ !>

Cured $ >9 >>



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(reatment completed > $ !>

Cured rate $#' !##' ?"'

Success rate @#' !##' ?'

Defaulter rate # # #

ailure rate # # #

Deaths rate # > 5$'8 $ 5!;'8

3f the total forty one 5!8 cases seen in >##?, si:ty three 5;9.'8 were smear positie, twenty

nine percent 5>@'8 were smear negatie whilst the remaining eight percent 5?'8 were e:tra>

*um)er of slides sent for rechec&ing wasM !!

+ositie slides for rechec&ing wasM !

*egatie 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 oer staining.

(he District has a num)er of microscope Centres as shown in the ta)le )elowJ

N#. #9 "%##' !/-!% > 501A ospital and /oso ealth Centre

F&,-! !&%"&%! 9#% ,& !%>! 5S. erry, Anum Salation Army, Apegusoand Ad4ena Clinic

N#. #9 9+/-#/&, "%##' / 9&,-! > 501A ospital and /oso ealth Centre8

T&,! : N+"!% #9 &! 9%#" 200200 (#/ / -(! -&,! !,#.

YEAR 200 200* 200

N#. #9 +'!-! TB

&! !-!-! !#" !$; >!"

N#. -!-! / ,&.

!#" !$; >!"

N#. -!-! '#->!

!# !> >"

Some of the innoations that the District has underta&en includes, colla)oration with *G3s intraining traditional leaders and community olunteers on (/, outreach programmes in churches

and mos%ues 5supported )y *G38 on (/, renoation of old mar&et stall at Senchi erry to

proide la)oratory serices, and a research to conducted at Anum /oso Su) District to detect

more cases


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Asuogyaman Tb 2009

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