The PROTECT project evaluated the impact of Tuberculosis Preventive Therapy (TPT) among People Living with HIV (PLHIV) following the TPT scale-up in selected CDC-supported comprehensive Antiretroviral Therapy (ART) sites across Nigeria during the period from October 2019 to September 2021. The primary objective was to assess TPT’s effectiveness in preventing new TB cases and reducing TB-related mortality among PLHIV. Additionally, the project also set out to evaluate the functionality of the newly introduced electronic TB module on the Nigeria Medical Records System (NMRS), which was developed in 2022. Notably, the facilities participating in this evaluation represent the pioneering sites where data entered into the new TB module will be submitted to the National Data Repository, providing crucial insights for national decisions regarding the scale-up of this innovative tool.

The project is anticipated to contribute valuable learnings that will inform future strategies and policies related to TPT and TB management nationally. We used various approaches to achieve our goals and objectives this past year. Firstly, we utilized the CDC’s Framework for Program Evaluation, aligning with Nigeria’s TPT Surge Plan and CDC–Nigeria’s NDR Protocol. Secondly, we engaged the Federal Ministry of Health, other implementing partners, and stakeholders through pre-evaluation, post-evaluation, and result utilization sessions.

In addition, we trained data entry clerks (DECs) on the project, NMRS and TB module, and data quality. The DECs were embedded for timely and validated data entry into NMRS. Furthermore, to ensure data quality during abstraction, we conducted field supervision, which included spot checks and peer reviews. Finally, we developed SQL scripts for de-identified data extraction from NDR.

• Conducted a comprehensive study in Delta, Rivers, Lagos, Kaduna, Federal Capital Territory (FCT), Nasarawa, Benue, and
• Plateau states to evaluate and determine the incidence of new TB cases and TB-related deaths in people living with HIV.
• Reviewed treatment records of people living with HIV on antiretroviral therapy between October 2019 and September 2021.
• Trained Data Entry Clerks (DECs) responsible for entering study data into the Nigerian Medical Record System (NMRS).
• Conducted data abstraction and entry in 60 facilities across 30 Local Government Areas in the nine selected states with a commendable completion rate of 96.6% across all facilities.
• Piloted the new TB Module in selected facilities to manage and track data related to tuberculosis (TB) and TB preventive therapy (TPT) for people living with HIV (PLHIV).
• Implemented supportive supervision through Field Implementation Coordinators and State Level Supervisors, ensuring data
• quality through a Data Monitoring Tool (DMT).