As COVID-19 continues to pose a grave danger to people’s health, other illnesses are also still eating up many of the victims, an example of which is the respiratory disease, Tuberculosis (TB).
While much effort and sensitization has been directed towards fighting the pandemic, other sections in the Ministry of Health and related parties are on ground with a continuous fight to prevent tuberculosis.
Dr Stavia Turyahabwe, Assistant Commissioner National TB and Leprosy Programme said that the recently developed strategic plan 2020/21 and 2024/25 for the fight against Tuberculosis will help to reduce the TB incidence in the country.
“The strategic plan is a people centred plan where we use the people-centred framework to inform our priorities but also looking at the UN high level meeting targets to make sure that we are aligned to the global targets to end TB by 2030,” Dr. Turyahabwe stated.
The 2014-2016 population-based tuberculosis prevalence survey indicates that at least 46 per cent of the infections are missed cases (not enrolled on treatment) who infect up to between 10 and 15 new people per year.
A report by the University Research Council-USAID Defeat TB Project reveals that most TB prevalence is in urban areas due to their high population densities.
Wakiso, Kampala and Mukono districts (the metropolitan area) are among the urban centres with the highest TB infection rates.
In 2018, out of 11,212 people screened, 352 were diagnosed with TB representing 3 per cent. Wakiso had 5,108 people screened with 301 testing positive to TB, representing 6 per cent while Mukono had 958 people tested with 62 (6 per cent) confirmed TB positive. All the above were done through TB contact investigations screening.
However, Dr Turyahabwe said that the responsible stakeholders are employing efforts to reach out to TB patients and ensure they access full treatment.
“Uganda aligned its target to the global commitment. We are looking forward to reaching out to over 90% of the people who developed TB in the country. Over 90% of TB patients need to go through the treatment successfully and over 90% of people that require preventive treatment must get it,” Turyahabwe explained.
TB and the less fortunate regions in the country
One of the underperforming regions in the country is Karamoja, where the bad treatment outcomes were reported to be outweighing the good treatment outcomes.
However, Dr Andrew Kambugu, Executive Director Infectious Diseases Institute (IDI) said that the life style of the Karamajong and the low social-economic levels coupled with other complications like malnutrition and poor road network have lessened TB treatment and outcomes.
“With the support of the national program and ‘Defeat TB’, we have undertaken a 3 prompt approach involving; the work we do in facilities, community interventions and the efforts we do with district and regional leaders,” he said.
Tuberculosis and HIV/AIDS
Dr Able Nkolo, Chief of Party USAID Defeat TB project said the organisation’s staff have played a big role in the TB response as concerns the vulnerability of the people living with HIV/AIDS.
“In the last 2 years, there were major issues that needed to be worked upon including the prevention of TB among people living with HIV as they are at great risk of acquiring TB,” Nkolo said.
It should be noted that about 20-30% of people living with HIV/AIDS are at a risk of developing TB.
“In 2018, about 6% of people living with HIV were on TB preventive therapy. In June 2019, ‘Defeat TB’ worked with MoH, National TB program, AIDs Control Program and other stakeholders to setup a campaign to initiate 3000 people living with HIV on TB preventive therapy. By the end of 100 days, more than 300,000 people living with HIV had been started on TB,” he further noted.
Dr. Nkolo said that currently, the treatment outcomes are at 90% and the coverage of TB preventive therapy is around 67%.
“We are working with stakeholders to take this higher,” he added.
Relationship between Covid-19 and TB
“The agents responsible for TB and Covid-19 are different; for TB, it’s a bacteria and for covid-19, it’s a virus. However, in terms of transmission, they all come from the lungs and are put out in the air,” Nkolo said.
The experts also mentioned that whereas TB bacteria stay in the air for quite some time, longer periods even after a person who coughed has gone away, the covid-19 viral particles quickly attach onto close surfaces.
Dr. Nkolo said that the emergence of covid-19 has re-enforced the wearing of masks, which is a great preventative measure for the spread of TB as well.