At a glance
Read how CDC works with the Vietnam Ministry of Health to develop new approaches to address the TB epidemic. Together, CDC Vietnam and its partners successfully implemented new technologies, identified opportunities for improvement, and implemented plans to sustain community support.
The challenge
Since 1998, the U.S. Centers for Disease Control and Prevention (CDC) has worked with the Vietnam Ministry of Health to support and expand programs that target priority diseases, including tuberculosis (TB). In 2020, Vietnam reported 172,000 cases of TB and ranked 10th globally among countries with the highest burdens of TB.
The burden remains high, but there has been progress - TB prevalence has declined by over 35 percent since 2007 and TB mortality dropped by 41 percent between 2015 and 2020.
This progress is due to use of innovative tools and techniques to reduce TB. These innovative techniques – rapid molecular testing and portable chest x-ray capabilities – have helped Vietnam continue to see progress in the fight against TB amidst global challenges.
New approaches
Photo by: Nguyen Hong Vu
According to the Vietnam National TB Program (NTP), the country is focused on applying these innovative techniques to priority areas, including remote provinces. These approaches are accelerating progress towards national targets for ending TB.
To help meet these targets and mitigate the impact of the COVID-19 pandemic on TB programs, CDC Vietnam and partners launched two new technological innovations in 2021:
- TrueNat - a mobile, near point-of-care rapid molecular test that can diagnose TB within an hour.
- A portable chest radiography (CXR) using a Fujifilm Xair device.
Both devices were designed with rugged portability and ease of use in mind, which is ideal for reaching individuals in remote areas of Vietnam.
CDC Vietnam implemented this project in partnership with the NTP and CRDF-Global and Friends for International Tuberculosis Relief (FIT) with support from the Coronavirus AID, Relief, and Economic Security (CARES) Act.
"We will find them"
Lai Chau is a rural northwest province with one of the lowest treatment rates for new and previously treated TB, as well as low notification rates of new cases. To address the historical gaps in TB programing for this province, experts from CDC Vietnam joined NTP staff and the FIT implementation team on a case finding trip to the remote area.
Working closely with area partners, the project team screened over 5,600 residents for TB using the portable CXR device. Community members were also screened for other health conditions, including high blood pressure, diabetes, asthma, and chronic obstructive pulmonary disease. CDC Vietnam, the NTP and FIT also provided assistance and recommendations for safely implementing TB screenings during COVID-19 using proven infection prevention and control protocols and biosafety best practices. The rate of people who tested positive by TrueNat suggested a much higher TB prevalence than reported in the local estimate. Preliminary results showed that 21 percent of participants eligible for tuberculin skin testing tested positive and were eligible for TB preventive treatment.
Both of these innovative technologies—CXR and TrueNat—have proven instrumental in identifying, treating, and preventing further TB infection in remote locations.
Considering Lai Chau's remote location, CDC Vietnam, the NTP and FIT took steps to alleviate the community's challenges accessing care. This included the provision of travel stipends for patient treatment and the continued use of TrueNat and portable CXR as convenient and feasible technologies there in the community.
CDC Vietnam's partnership with the Government of Vietnam strives to tackle TB on numerous fronts, and we're proud to have been a part of the progress Vietnam has made thus far.
This project is another example of CDC's efforts to provide support and direct technical assistance that will improve the capacity of Vietnam's healthcare system. Piece by piece, it will accelerate progress towards Vietnam's TB elimination targets.
Applying lessons learned
With TrueNat and CXR, CDC Vietnam and partners were able to provide innovative tools for TB screening in the field. CDC Vietnam and partners also trained public health staff on how to interpret and troubleshoot the technologies. Use of these technologies will also help to accurately assess district-level TB disease trends. Lessons learned in Lai Chau will be applied to further TB screening campaigns planned in remote ethnic minority communities in three additional provinces.
Together, CDC Vietnam and partners successfully implemented new technologies, identified opportunities for improvement, and implemented plans to sustain support to communities. By collaborating with all levels of government and providing community-based support and feedback, CDC Vietnam continues to serve as a valued partner in strengthening Vietnam's capacity for TB care and prevention.