Dissemination Workshop

Screening for Tuberculosis, COVID-19, and Common Respiratory Infections at Primary Healthcare Facilities in Viet Nam

Press Release

Innovations Enhancing Effectiveness in Tuberculosis, COVID-19, and Common Respiratory Infections Screening in Viet Nam

The COVID-19 pandemic has adversely affected tuberculosis (TB) control efforts, exacerbating the already high burden of TB in Viet Nam. The demands of COVID-19 prevention indirectly reduced activities related to TB case detection, limited access to healthcare services, decreased treatment effectiveness for patients, and increased the risk of exposure among healthcare workers. The World Health Organization (WHO) has emphasized the importance of maintaining TB prevention and care during the pandemic, highlighting the significance of bidirectional screening for TB and COVID-19 as a core activity that needs to be implemented.

COVID-19 has also underscored the importance of testing in healthcare activities, alongside the critical requirements for quality diagnostic tools, adequately skilled healthcare personnel to conduct diagnostic testing, and infrastructure such as machinery, equipment, laboratories, data management systems, as well as supportive policies and rational allocation of available resources.

In this context, the National Tuberculosis Control Program (NTP) and FIND have collaborated to implement the project “Screening for Tuberculosis, COVID-19, and Common Respiratory Infections at Primary Healthcare Facilities in Viet Nam” from September 2022 to June 2023 with the following objectives: (i) Enhancing the capacity of PHFs in conducting multidirectional testing for COVID-19, TB, and common respiratory infections; (ii) Demonstrating the feasibility of integrated testing models for COVID-19, TB, and common respiratory infections at primary healthcare facilities; (iii) Assessing the impact of this testing model at PHFs on TB testing.

The project was implemented in Ung Hoa and Phuc Tho districts, Ha Noi, with 57 healthcare facilities participating, covering 55 communes with a population of approximately 524,000. Individuals with symptoms of acute respiratory infection were screened for COVID-19, Influenza A, B, and Respiratory Syncytial Virus (RSV). Children under 15 years old with respiratory symptoms or rash, lymphadenopathy, nausea, and vomiting were tested for Group A Streptococcus, in addition to COVID-19, Influenza A, B, and RSV testing. Symptomatic TB cases or those at high risk of TB infection were sampled for sputum at commune health stations and sent to the district health centers for TB testing using the GeneXpert method – capable of detecting drug-sensitive and drug-resistant TB. This was the first time that district health centers participated in a project supported to perform Xpert-based TB testing. Detected TB cases were treated at district health centers, while drug-resistant TB cases were referred to Ha Noi Lung Hospital. Particularly, the TBCOVID software (tbcovid.vn) was developed to support screening, testing, data entry, and reporting at healthcare facilities.

Initial results show positive impacts from the project. Within 6 months of screening implementation, a total of 22,604 individuals were screened for TB, COVID-19, and other respiratory infections. Among them, 3,776 individuals were screened for TB, with 78 cases of regular TB detected, and 3 cases of drug-resistant TB. This figure is tens of times higher than the number of cases detected in the two districts in 2021 and 2022. These results demonstrate the importance of enhancing testing capacity for PHFs, especially in the context of COVID-19 and TB. This evidence is crucial to support policy development and implementation in Viet Nam and beyond.

Once again, the project emphasizes the efforts of NTP and FIND in supporting the enhancement of diagnostic capacity at PHFs, thereby improving access to essential diagnostics for the population, especially in challenging areas, while improving the quality of disease management and surveillance at PHFs. The project also opens up prospects and directions for FIND’s future activities in partnership with NTP, to pilot and implement new initiatives and models aimed at enhancing TB detection and moving towards TB elimination by 2035.