General Enquiries 41060501-24
Home  /  USAID’s ACTB

USAID’s Alliance for Combating in TB Bangladesh (USAID’s ACTB)

USAID’s Alliance for Combating in TB Bangladesh (USAID’s ACTB) Project

   1. Background:

Tuberculosis (TB) remains one of the world’s deadliest communicable diseases. The burden of diabetes is increasing globally in general and also in Bangladesh in specific. Bangladesh is known as a high TB burden country with incidence rate and mortality rate of 221/ 100,000 and 36/100,000 populations respectively. The total number of diabetic patients increases day by day in Bangladesh with an estimated number of 7.1 million people. The association between DM and TB and their synergistic role in causing human disease has been recognized for a long time. Most health systems address diabetes and TB as vertical service delivery programs separate from each other in spite of the clear interaction between the two diseases. Since TB – DM comorbidity requires special care, it’s crucial to identify DM patients who are already suffering from TB. On the other hand, TB can be a consequence of DM. Diabetes may change the clinical presentation of TB, making it difficult to diagnose and manage. If we address these two diseases under a common frame or umbrella then we can able to ensure quality and comprehensive care to patients with TB-DM comorbidity which will allow limited-resource countries like ours to maximize their efficiency with minimum use of resource expenditure.

   2.About BADAS:

The Diabetic Association of Bangladesh (Bengali acronym Bangladesh Diabetic Somiti- BADAS) was established on 28 February 1956 in Dhaka at the initiative of the late National Professor Dr. Muhammad Ibrahim (1911-1989). BADAS as a nonprofit voluntary socio-medical service organization was registered with the Ministry of Social Welfare under the Society’s Registration Act, of 1860.
Vision:

  1. In Bangladesh no diabetic should die untreated, unemployed, or unfed.
  2. All people shall be provided with affordable healthcare services.

Mission:

  1. Provide total health care including rehabilitation for all diabetics irrespective of gender, economic and social status.
  2. Provide affordable BADAS health care for all Bangladeshi through self-sustaining centers of excellence.
  3. Create specialized quality manpower
  4. Develop leadership in healthcare

   3. BADAS TB Initiative:

BADAS keeping synergy with the scenario of Bangladesh has taken the guidance of NTP & financial support from USAID through URC and MSH has been working since 2013 with an integrated platform with a comprehensive multi-component approach to minimize the dual burden of TB – DM comorbidity in our country. BADAS closely worked with NTP since 2013 to deal with the TB – DM comorbidity in various activities and programs. BADAS is solely working in this sector with support from NTP. Through this period from April 2013 to May 2019, BADAS has identified more than Eighty thousand presumptive TB cases and from which identified nearly 8,619 TB patients. Now, in conjunction with USAID and ICDDR, B BADAS has been awarded a project titled USAID’s Alliance for Combating TB in Bangladesh.

A glimpse of the activities is mentioned below,

  • Detection, Management, and Referral of TB cases,
  • Strengthening providers’ capacity in TB-DM diagnosis & case management
    • Through Orientation & Training Programs for Doctors, Nurses & Allied staffs
    • Coordination sessions with Specialist Physicians.
  • Laboratory Services with Gene X-pert (BIRDEM Hospital).
  • Contribution to the FAST (Finding, Actively, Separating, and Treating) program at BIRDEM,
  • Important SBCC activities undertaken,
  • Community Awareness Meeting
  • Radio & TV Program
  • Round Table Meeting with Media
  • SMS Campaign
  • Day Observation

Quantitative data of BADAS throughout the years (Compiled Data of TB Care II & Challenge TB Bangladesh projects funded by USAID through URC and MSH respectively)


Indicator

Achievement (April,13 –May,19)

Number of patients identified & Tested as TB presumptive

81,201

Total number of patients diagnosed as TB

8,619

Number of patients put on treatment

8,457

Number of Counseling sessions held

38,635

Number of Patients oriented through counseling sessions and IPC

1,239,589

Number of Doctors, Nurses, and other Health Workers oriented/trained on TB-DM Co-morbidity

2,654

Impact of BADAS TB-DM Initiative:

  • With the help and support of the local Government Authorities and different partners working in the local TB field under NTP, a total number of 13 new Sputum Collection centers were established at different BADAS Affiliated Centers throughout Bangladesh.
  • With the support and direction of NTP, BADAS has completed a National Guideline for the proper management of patients with TB–DM co-morbidity. For that purpose, had developed ‘National Guidelines for the Management of TB DM Co-morbidity’ for doctors.
  • For proper awareness generation among DM patients, with the direction of NTP, BADAS TB Initiative added some important TB-related information to the “Diabetic Patients’ Guidebook”

USAID’s Alliance for Combating TB in Bangladesh, BADAS (USAID’s ACTB, BADAS):

USAID Bangladesh Office has awarded to a consortium of five Bangladesh-based organizations – the Alliance for Combating TB in Bangladesh, or ACTB – led by icddr,b to accelerate Bangladesh’s fight against TB. This is a response to USAID’s local organization’s network project (LON) funding opportunity number 7200AA19APS00001.
BADAS runs as a nonprofit entity with its own extensive network of affiliated academies, institutions, doctors, and allied health professionals, and country-wide health service delivery points will utilize its Multi-sectoral approach to reduce the dual burden of TB–DM comorbidity.
Objective:

  1. To implement collaborative activities to reduce the dual burden of TB and Diabetes through early case detection and management.
  2. To strengthen the capacity of health service providers in TB-DM diagnosis and case management.
  3. To develop awareness among DM patients and the mass population about TB-DM co-morbidity.

Working Area:
92 centers of the Diabetic Association of Bangladesh throughout the country. Map of Bangladesh showing the Affiliated and Sub affiliated centers of the Diabetic Association of Bangladesh (BADAS).

Activities:
The following activities will be implemented to achieve the project objectives:

  • Active case finding at Diabetic care centers
  • Referral of Presumptive TB cases to nearby DOTS centers.
  • TB-DM Case Management by center doctors and referral.
  • Laboratory Service (Gene x-pert at BIRDEM).
  • Contact tracing & Household visits.
  • SBCC & Training programs – Diabetic camps/ Advocacy Meetings/ Community Meetings/ Workshops/ Orientations, etc.
  • Develop private providers’ capacity through a Certificate Course on Diabetology.

Achievement:

  • Ongoing ACF at 92 BADAS centers.
  • Identified and tested more than 104,552 presumptive cases and diagnosed a total of 9,701 TB cases.
  • Ongoing incorporation with Certificate Course on Diabetology (CCD) and trained approximately 1,600 physicians on TB-DM comorbidity management.

DM Background and Opportunity in Bangladesh:

The Diabetic scenario in Bangladesh is quite unique. Here the prevalence of Diabetic is gradually increasing day by day. According to the International Diabetic Federation, in 2021 the estimated Diabetic population in Bangladesh is 13.1 million, among which 43% (5.7 million) remain undiagnosed. The Diabetic Association of Bangladesh (BADAS) provides various healthcare services to approximately 3.4 (3.0 – 3.8) million people through its nationwide healthcare centers each year. It is 45% of the total diagnosed diabetic patients and nearly 25% of the total estimated diabetic patients in Bangladesh. The USAID’s ACTB, BADAS in 2022 has detected a total of 3,472 TB cases from more than 44,000 Presumptive cases by screening nearly 1 million people. So, it seems there is a lot of work to be done.