Rose and Thorns towards ending TB

The fact that Malawi ended Polio in 1992 should be motivation enough to hope; this country could eradicate TB come 2035 – not surprising the country has set itself a more ambitious dream to move towards ending Tuberculosis at least by 2030.

Not surprising therefore; authorities have identified over 1 500 community sputum collection points being managed by a battalion of over 15 000 volunteers nation-wide tasked to conduct TB case-detection campaigns and linking suspected cases to medical facilities.

Poor living standards fuel bad health.

Ordinarily having invested so much in: mobile vans, community sputum collection points and house-to-house TB screening one would expect better patient-and-treatment outcome from these efforts, which have also included contact-investigation as principle strategies to fighting TB.

However, because every coin has two sides; the road to eradicating TB would have to begin with some reflection on gains and losses being posted this far.

On the positive; Isaiah Dambe deputy national coordinator for the TB Control Program, has told MIJ Online the program was so far impressed with progress being registered in the fight against the disease.

He cites interventions put in place like: contact investigations, mobile vans and community sputum collection points being used as a vehicle to detecting TB cases and recommending them for medical care.

“Although some of these interventions like mobile-vans could be expensive to manage; but as a program, we are impressed with the differences being made in the communities,” said Dambe, citing cases of improved community involvement.

But challenges aren’t only restricted to costs; because, community sputum collection seems a high risky venture as health workers and volunteers alike run the greater risks of contracting TB each time attending to TB presumptive patients or worse still TB patients themselves.

Poor ventilation in peoples houses has been a challenge.

However, in spite of such interventions, the fight against TB still has challenges unlimited as some sections of the society are posting an unprecedented slow progress.

Meanwhile, amongst key setbacks, eastern region districts of Machinga and Mangochi are recording low treatment outcomes and high TB death rate – a course for worry when authorities seem to be clueless about this phenomenon.

Confessing of the development; Henry Kanyerere, TB and HIV program officer for the TB Control Program, is however blank about factors leading to rise of death rate in Machinga and Mangochi.

“This is a dilemma which we have most specifically in terms of treatment outcome for TB cases registered in these districts. The reasons we are not quite sure but we are suspecting it could be for high death rates … but we are yet to investigate to understand this pattern,” said Kanyerere.

Unhealth places of work also behind poor health.

On the hand, of late, this fight against TB seem to have lost some grip.

Come to think of this scenario where there’s been a rise in cases of Pediatric TB of 9 % as evaluated in the year 2018 and 2019.

Said Kanyerere: “Its’ true there’s been an increase from 2018 to 2019. In 2018 we had 1 391 TB cases among children and 2019 we had 1 521 on the positive side we are attributing this to an increase in number of health workers who have trained.

“And on the other hand; it means there are some practices that need to be addressed as some of these children could be contacting TB from index cases who are household members and oftentimes mothers,” said Kanyerere.

These developments are happening at a time the country is chasing a 2035 target to erase the disease as prescribed by the World Health Organisation.

 

Meanwhile, the country is implementing a bunch of interventions aimed at combating TB.

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