Low awareness hinders TB diagnosis and treatment
“The community is not coming forward because they are not aware; only 51 percent of all cases are diagnosed,” said Dr Francis Adatu, manager of the National TB and Leprosy Programme in the Ministry of Health.
According to the ministry, about five percent of Ugandan patients who start TB treatment die, and even though the country has almost 800 centres capable of diagnosing the disease, many of them are not manned by health workers qualified to treat the disease.
The 2009 Global TB Control report by the UN World Health Organization (WHO) notes that only one-third of Uganda’s TB cases are successfully treated, despite following the community-based directly observed treatment short course (DOTS) system, in which patients take their medicine in the presence of an observer.
In 2006 an estimated 13 percent of patients who started TB treatment defaulted, jeopardising the success of the regimen. “The treatment success rate remains low because of the high proportion of patients who die, default from treatment, or for whom the treatment outcome is not evaluated,” the report stated.
“People treat the common cough with simple syrups and traditional herbs like ginger; when it is a difficult cough, patients go to health centres, private practitioners and traditional herbalists, which can lead to low diagnosis,” said Sophia Apio Kerwegi, a senior researcher at Uganda’s Natural Chemotherapeutics Research Laboratory. “Sometimes they come when the TB is in its active stage ‘ the best time for diagnosing is during the latent stage.”
Dr Jim Reeves Lutangira, another local TB researcher, commented: “Many come for diagnosis [but] after two weeks’ treatment they disappear, when symptoms like coughing go away, they abandon drugs and get drug-resistant TB.”
In 2007 there were 485 new cases of multidrug-resistant TB in Uganda, according to WHO, but only seven were diagnosed and received treatment.
The government is trying to strengthen its DOTS system, and adherence to the drug regimen has risen to about 67 percent where community ties are strong, but in other areas such as northern Uganda, where people were displaced by a 20-year war and are now returning to their villages, they live far from each other and from health services, so adherence is low and TB continues to spread. In Gulu district, which was badly affected by the war, cases rose from 1,369 in 2007 to 1,936 in 2008, largely because of poor monitoring of drug regimens.
Uganda recently experienced a shortage of TB medication, which the government blamed on delays in the disbursement of money by the Global Fund to fight AIDS, Tuberculosis and Malaria. The health ministry purchased drugs from neighbouring Kenya as a stop-gap measure, but poor supply chain management has regularly caused shortages of essential drugs.
More than 80,000 new cases of TB are diagnosed in Uganda every year, with 60 percent of patients co-infected with HIV. The country is ranked 15th on WHO’s list of 22 high-burden countries.
This feature is used with permission from IRIN/PlusNews – www.plusnews.org
Author
Health-e News is South Africa's dedicated health news service and home to OurHealth citizen journalism. Follow us on Twitter @HealtheNews
Republish this article
This work is licensed under a Creative Commons Attribution-NoDerivatives 4.0 International License.
Unless otherwise noted, you can republish our articles for free under a Creative Commons license. Here’s what you need to know:
You have to credit Health-e News. In the byline, we prefer “Author Name, Publication.” At the top of the text of your story, include a line that reads: “This story was originally published by Health-e News.” You must link the word “Health-e News” to the original URL of the story.
You must include all of the links from our story, including our newsletter sign up link.
If you use canonical metadata, please use the Health-e News URL. For more information about canonical metadata, click here.
You can’t edit our material, except to reflect relative changes in time, location and editorial style. (For example, “yesterday” can be changed to “last week”)
You have no rights to sell, license, syndicate, or otherwise represent yourself as the authorized owner of our material to any third parties. This means that you cannot actively publish or submit our work for syndication to third party platforms or apps like Apple News or Google News. Health-e News understands that publishers cannot fully control when certain third parties automatically summarise or crawl content from publishers’ own sites.
You can’t republish our material wholesale, or automatically; you need to select stories to be republished individually.
If you share republished stories on social media, we’d appreciate being tagged in your posts. You can find us on Twitter @HealthENews, Instagram @healthenews, and Facebook Health-e News Service.
You can grab HTML code for our stories easily. Click on the Creative Commons logo on our stories. You’ll find it with the other share buttons.
If you have any other questions, contact info@health-e.org.za.
Low awareness hinders TB diagnosis and treatment
by Health-e News, Health-e News
March 25, 2009