Cambodia is one of twenty-two countries with a high Tuberculosis (TB) burden. At present, the incidence rate of all forms of TB is projected at 380 per 100,000 inhabitants, and it is estimated that at least58per 100,000 Cambodians die of tuberculosis annually. The Ministry of Health's response to these high mortality rates is to incorporate the World Health Organization's internationally recommended treatment: the Directly Observed Treatment Short course (DOTS), a decision which has been met with enthusiasm by local health organizations. RACHA works in our target areas to combat TB and HIV/AIDS, both of which are still a danger to many Cambodians.
RACHA has been working to combat TB in line with the Global and National Strategy and Plan by expanding and strengthening DOTS strategy in all health centers and communities (C-DOTS). The DOTS strategy, developed by the World Health Organization, has five main components: sustained political and financial commitment, diagnosis by quality ensured sputum-smear microscopy which will reliably find infectious patients, standardized short-course anti-TB treatment which ensures the right drugs are taken at the right time, a regular and uninterrupted supply of high quality anti-TB drugs, and standardized recording and reporting which keeps track of both individual patients and overall program performance. RACHA aims to increase patients' accessibility to TB services, improve the case detection rate and maintain a high cure rate.
RACHA ensures maintenance of quality services through on-going technical assistance, capacity building, and supervision to health center staff, DOTS watchers. RACHA relies on thousands of volunteers to carry out the important work of fighting TB.
Improved Effectiveness and Efficiency of TB is one of the objectives of RACHA’s current USAID-funded Empowering Communities for Health (ECH) project. RACHA supports the Capacity Building of health center (HC) staff in TB and the VHSGs bi-monthly meeting at HC or CC Level.
In 2016, RACHA has conducted Semi-Active Case Finding (SACF) in 229 pagodas of 145 HCs and Contact Investigation (CI) outreaches in 215 HCs. As a direct result of these activities, 29,543 people were screened by the HC and 376 cases of TB were diagnosed with87 cases in children less than 15 years. Over the last 12 months, a total of 361 (F: 215) of C-DOTS watcher have received C-DOTS refresher training and 5,365 (F: 3,275) VHSG received TB information as part of the VHSGs bi-monthly meeting.
RACHA has established effective collaboration and support from VHSG/C-DOTS watchers, OD, HC, and referral hospital staff in conducting Active Case Finding (ACF) and Contact Investigation (CI) activities. The participation of CCWC trainings is a key activity that improves CCWC understanding on the need for community TB early detection and early treatment outreach.