Update on Health Statistics in Samoa
The health statistics in Samoa reveal challenges and progress in managing HIV, syphilis, and tuberculosis cases. As of 2021, there are 13 people living with HIV in Samoa, with an increase in syphilis cases compared to the previous year. The country has seen no patients with multi-drug-resistant tuberculosis in the last 10 years. Efforts are ongoing to provide treatment and care for those affected by these diseases.
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Presentation Transcript
Samoa Family Health Association Samoa Faafafine Association Samoa Ministry of Health
13 people are living with HIV 10 Males, 3 Females 2 people < 16years All on ARV Therapy, 3 on private care Most recent case detected 2020 This case was diagnosed & registered in Samoa but has now returned home to their country not included in the 13 Another 2 diagnosed in 2018 Cumulative HIV cases since 1990 is 27 (13 deceased)
Increasing number of syphilis case detection in 2021 gradual increase of congenital syphilis cases on treatment 135 confirmed cases of syphilis in 2021 (up to Oct 15th) compared to only 56 confirmed cases in 2020. Noted decrease in STI/HIV voluntary screening & testing from Measles Epidemic to COVID19 Pandemic SOE restrictions & lockdowns The number of testing in 2021 for all STI s decreased by 39% compared to 2019 The largest decreases in tests were observed in testing for chlamydia and gonorrhea (a 91.5% and 90.8% decrease respectively)in 2021 compared to 2019
Monthly Detected HIV, STI and Hepatitis Lab Confirmed Cases by Date Tested and Total Testing 1st Jan. 2017- 15th Oct. 2021 Measles Outbreak Declared 15th Oct 2019 Borders close for COVID19 Pandemic measures April 2020 1 new HIV registered on treatment (imported case) Aug 2021 200 6000 180 5000 160 140 Significant increase in syphilis cases July 2021 (mostly mother to child transmission) 4000 120 100 3000 80 2000 60 40 1000 20 0 0 Mar-17 Mar-18 Mar-19 Mar-20 Mar-21 May-17 May-18 May-19 May-20 May-21 Jan-17 Jan-18 Jan-19 Jan-20 Jan-21 Nov-17 Nov-18 Nov-19 Nov-20 Sep-17 Sep-18 Sep-19 Sep-20 Sep-21 Jul-17 Jul-18 Jul-19 Jul-20 Jul-21 Chlamydia Gonorrhoea Hepatitis A Hepatitis B Hepatitis C Syphilis HIV Total Tests (HIV, STI, & Hepatitis)
No patients with MDR TB in the last 10 years 13 sputum-positive confirmed cumulative cases between Jan-Dec 2021 Only 1 TB patient diabetic 1 sputum-positive confirmed case for 2022 26 children (5 yrs + <) completed Isoniazid prophylaxis 2021 23 Latent TB cases completed treatment in 2021 3.6 per 100,000 case notification rate all forms of TB
Number of Tuberculosis Cases from 1995- - 2021 Number of Tuberculosis Cases from 1995 2021 60 51 50 50 NUMBER OF CASES DETECTED NUMBER OF CASES DETECTED 46 44 40 36 34 32 30 30 27 26 26 24 23 22 22 22 22 20 19 19 19 17 14 14 13 13 13 11 10 0 1995 1996 1997 1998 1999 2000 2001 2002 2003 2004 2005 2006 YEAR OF DETECTION 2007 2008 2009 2010 2011 2012 2013 2014 2015 2016 2017 2018 2019 2020 2021 YEAR OF DETECTION
2021 Target 2021 Results NumeratorDenominat Rate NumeratorDenominat Indicator Name Rate Achievement Rate or or Percentage of men who have sex with men who are living with HIV 0% 0 445 0% #DIV/0! Percentage of transgender people who are living with HIV 0% 0 1381 0% #DIV/0! Percentage of sex workers who are living with HIV 0% 0 28 0% #DIV/0! TB mortality rate per 100,000 population 0.59 2 198410 1.01 120% 0% 0 13 0% 0% RR-TB and/or MDR-TB prevalence among new TB patients: Proportion of new TB cases with RR-TB and/or MDR-TB 90% 9 11 82% 91% Percentage of people living with HIV and on ART who are virologically suppressed 30% 541 849 64% 120% Percentage of men reporting the use of a condom the last time they had anal sex with a male partner 88% 1371 1381 99% 113% Percentage of transgender people reporting the use of a condom the last time they had sex with a partner 48% 28 28 100% 120% Percentage of sex workers reporting the use of a condom with their most recent client 100% 0 0 #DIV/0! #DIV/0! Treatment success rate of RR TB and/or MDR TB. Percentage of cases with RR and/or MDR TB successfully treated 91% 13 21 62% 68% TB treatment coverage: Percentage of new and relapse cases that were notified and treated among the estimated number of incidentTB cases in the same year (all form of TB - bacteriologically confirmed plus clinically diagnosed) 886 870 98% Number of men who have sex with men reached with HIV prevention programs - defined package of services 700 445 64% Number of men who have sex with men that have received an HIV test during the reporting period and know their results 1222 1383 113% Number of transgender people reached with HIV prevention programs - defined package of services 1137 1381 120% Number of transgender people that have received an HIV test during the reporting period and know their results 48 28 58% Number of sex workers reached with HIV prevention programs - defined package of services 46 28 61% Number of sex workers that have received an HIV test during the reporting period and know their results 100% 11 92% 92% 12 Percentage of people living with HIV currently receiving antiretrovial therapy 13 68% 19 Number of notified cases of all forms of TB (ie bacteriologically confirmed + clinically diagnosed), includes new and relapse cases 91% 11 13 85% 93% Treatment success rate - all forms: Percentage of TB cases, all forms, bacteriologically confirmed plus clinically diangosed, successfully treated (cured plus treatment completed) among all TB cases registered for treatment during a specified period, new and relapse cases 0 0% 0 Number of TB cases with RR-TB and/or MDR-TB notified Number of RR-TB and/or MDR-TB that began second line treatment 0 0% 0 5 #DIV/0! Number of TB cases (all forms) notified among key affected populations/ high risk groups (other than prisoners) Average Indicator Performance 85% Performance Rating B1
Key achievement of HIV/ TB National Programs (MoH, SFA, SFHA and partners) Prevention HIV/TB & Community Systems Strengthening Increase in multimedia Campaigns amidst the C19 restrictions increasing T3 talk it, test it, treat it campaign PLWHIV all well & adherent to treatment Most took part in COVID19 workshop for PLWHIV Integration of SD Duo testing into all outreach programs was a success National University of Samoa intervention target of 150 students to be tested the program test 307 students, together NUS staff USP Open Day 117 tested Ongoing integration of health talks on HIV/TB into C19 live radio programs Utilizing social media platforms (Facebook) to increase coverage of HIV/TB issues.
Key achievement of HIV/ TB National Programs (MoH, SFA, SFHA and partners) contd Integration of ICHAP program with the PENf for communities Testing and Screening for MSM is ongoing Testing and Screening of Sex Workers is ongoing Testing and Screening of seafarers and hotel workers TGs and MSM are also captured in for testing and PPD Safe space Market Day activities showcased talents and produce by the fa afafines using the opportunies to test with SDDuo test kits Sports activities twice last year for both Savaii and Upolu targeting all faafafines testing and safe sex packages (prevention packages) distributed to all participants World TB day commemoration integrated into ICHAP World AIDS Day & integration of 16 days of activism on violence against women led by YWCA, and MWCSD addressing GBV in any/all forms.
Key achievement of HIV/ TB National Programs (MoH, SFA, SFHA and partners) contd Capacity Building: Integration of C19, HIV/TB, syphilis, healthcare waster management, contact tracing and surveillance into the Traditional healers* 3 day workshop Strengthening partnerships with partners of national HIV/TB Programs through ongoing meetings on a quarterly basis M&E visit/onsite training for both Upolu and Savaii islands in Q4 Covered follow up of old & new TB patients and families, spot check of DOTs, TB and HIV/STIs data collection but also general hygiene education in the communities as well as preparedness for CV19 Onsite training of nurses to utilization of SDDuo test and teaching on Syhphilis
Key achievement of HIV/ TB National Programs (MoH, SFA, SFHA and partners) contd Training of mid-wives and pediatric nurses on congenital syphilis raising awareness about the increase in stats Importance of testing and early treatment Virtual workshops utilized to continuously build the capacity of our clinicians eg: Dr Catherine O Connor and Dr Bartlett of UNSW were able to provide online training on syphilis and STIs
C-19RF programmes (MoH & SFA) Strengthening health systems: Support procurement of medical equipment for our Communicable Disease Clinic (direct by UNDP) Support procurement of consumables for the CDC and for National C19 Response ie: PPEs etc, healthcare waste products etc Capacity building activities for our Surveillance team Community Systems Strengthening (SFA) Community testing and Screening programs targeting both Upolu and Savaii Faafafines ongoing
Commitment to submit completed acquittals in particular supporting documents on time delays due to shifting of priorities to CV19 and National Response Local Processing delays between MOF and MOH ie: wrong posting/charging other outputs with expenditures of another output and vice versa Overwhelmed and understaff finance team Multiple projects being handled by 2 staff members Shortages of supplies of main items needed for interventions or supplies are scarce Strict monitoring mechanisms put in place by our Internal Auditors delays submissions to MOF further
Commitment to submit completed acquittals in particular supporting documents on time delays dues to shifting of priorities as well as delays within local processes between MOF and MOH CV19 restrictions and lockdowns delays implementation OR complete change of approaches to key activities constant alternation and approval of programs to suit restrictions further delaying processes Staff succonded to CV19 National Response from time to time Implementing partners are also mobilized for CV19 response during SOE restrictions ICHAP difficult to achieve due to restrictions of not more than 30 people Only1 M&E was implemented Due to CV19 restrictions and staff involvement in national response
Targets set for testing and screening of Faafafines (SFA) were not meet due to ongoing recruitment RSE (Regional Seasonal Employment) scheme Many took up the opportunity resulting in low numbers to test and screen, same for MSM target groups Difficult to test female sex workers (Teine Vili Ata) due to fear of discrimination and stigmatization with the more obvious SOE restrictions in place Often leaving feeling more vulnerable and too exposed TB Case Detection difficult due to limited resources No TST for 2 years for contacts of TB patients Delay in Procurement Supply Management, Forecasting and Quantification, Msupply, stock Reports System still lacks integrity due to staff turnover from time to time thus affecting proper reporting of stock on hand and stock out.
Cartridges to test for VLs of PLWH is out of stock and supplies are delayed ARV medicine for PLWH are delayed
Integration of HIV/TB activities with CV19 activities funded by other projects or local budgets to avoid delay HR issues will be resolved with Senior M&E officer (April 2022) Support for a UNDPGF Snr Project Finance Officer to ensure timely submission of acquittal/financial reports on a quarterly basis. Contingency plans in place in case of any other future lockdowns Change approach to community awareness programs ie: ICHAP due to restrictions of not more than 30 people in a place, to another more effective approach hence Contingencyplans be ready.
Utilization 10% of savings under local budget whilst waiting disbursement of funds If PR can acquit also the committed items as part of the 80% BR to await submission of all documents ie treasury listing to confirm payment is made; moreso keep the flow of funds going between the PR & SRs Communication between PR and SR needs to improve ie: online meetings mid quarters to follow up on already implemented activities. Virtual meetings is more effective than email. Early delivery of diagnostic tests ie: TSTs (highlighted again in our Stock Report Q4 2021) Cartridges for VLs need to be delivered (highlighted in our stock report Q4 2021)
SDDUO testing & screening During WAD21 T3 pouches with condoms, lubs and T3 information cards M&E M&E checking on one of the suspected TB cases in the community checking on one of the suspected TB cases in the community WAD21 and 16 Days of Activism against violence WAD21 and 16 Days of Activism against violence Checking on a family of a TB casein Savaii and place children under 5 on Profylaxis Checking on a family of a TB casein Savaii and place children under 5 on Profylaxis treatment treatment ICHAP in collaboration with PENf ICHAP in collaboration with PENf Onsite SDDUO training for nurses in the rural district health Onsite SDDUO training for nurses in the rural district health centres centres Director General of Health during WAD21 Director General of Health during WAD21 Nurse administering TST on a contact of a confirmed TB case Nurse administering TST on a contact of a confirmed TB case M&E and DOTS follow up M&E and DOTS follow up Onsite SDDUO training for nurses in rural district health centers Onsite SDDUO training for nurses in rural district health centers
