TB hits pupils, teachers

MARACHA - Maracha district health officials have raised concern over the alarming spread of tuberculosis (TB) among schoolchildren, with over 200 cases reported. 

Dr Paul Onzubo, the district health officer, revealed that 206 pupils and a few community members have tested positive for TB, most of them children aged between nine and ten years in lower primary classes. 

“TB is not hereditary; it spreads through person-to-person contact, particularly in congested spaces with poor ventilation,” Dr Onzubo explained. 

“It’s easily transmitted through coughing, sneezing and even spitting, especially in schools where classrooms are overcrowded.” 

Dr Onzubo said TB, while primarily affecting the lungs, can impact other parts of the body, such as the spine. 

Common symptoms include a persistent cough, weight loss and reduced appetite. He warned that classrooms with poor air circulation present a serious risk for TB transmission among learners. 

Although TB is curable, treatment is costly. The Government currently offers treatment at Arua Regional Referral Hospital. 

Dr Onzubo emphasised the importance of the BCG vaccine, which is administered at birth and provides some protection. 

However, Maracha district currently has only a 63% vaccination coverage, leaving 37% of the population unvaccinated. 

Kololo Primary School, located away from the DR Congo border where most cases were initially suspected, reported 41 positive cases out of 119 randomly tested pupils. 

The school has 458 learners squeezed into a single classroom, far beyond the ministry of education’s recommended capacity of 45 pupils per classroom. 

Thirty-two of the infected children have been admitted to Arua Regional Referral Hospital for treatment. 

“Our children need real solutions, not temporary measures like tents. We need permanent structures and better classroom space,” Dr Onzubo stressed, calling on the ministry to build more classrooms. 

The mass screening was conducted by Community Awareness Screening for Tuberculosis (CAST). In addition to the pupils, two teachers have also tested positive for TB. 

A teacher from Offudee Primary School in Alikua sub-county urged that all schools in Maracha be screened and contacts of positive cases followed up for treatment. 

He also emphasised the importance of routine BCG vaccination and widespread awareness to prevent infections. 

He proposed termly screenings in schools, prioritisation of health education and development of a TB response plan for submission to the Ministry of Health. 

Edward Andruga, the district education officer, said classroom congestion is a major challenge, with some schools — like Ojapi and Nyoro Primary schools — reporting over 818 pupils in Primary 1 and 2. In many classrooms, nine learners are forced to share a desk meant for three. 

Andruga added that high temperatures during the dry season worsen the situation, making children more susceptible to infections. 

Monica Koliba Kotevu, the deputy resident district commissioner and chair of the district TB taskforce, attributed the rise in TB cases partly to Uganda’s porous borders, especially with children crossing from DR Congo to access education.

Maracha LC5 chairperson Stephen Obitre expressed concern over the district’s declining performance in TB management. 

“In 2023, we ranked second best in TB control, but now we are seeing rising cases. It means we have relaxed,” he said, urging local leaders to sensitise communities about TB prevention. 

Wilfred Azima, zonal co-ordinator for headteachers in Maracha, recommended forming TB taskforces in every school to guide learners, offer counselling and engage parents in identifying and referring cases of chronic cough. 

Francis Erema, the deputy headteacher of Kololo Primary School, said the school has 1 538 pupils and only 19 teachers. He said TB screening may fall short due to the overwhelming numbers and limited resources. 

The school also shares a borehole with Kololo Secondary School, raising further concerns about the spread of TB. 

Aleni Onzimuke, a class teacher, confirmed that some learners have refused to attend class due to the stigma surrounding TB. 

He also mentioned one confirmed TB case among staff living in the teachers’ quarters. 
Dr Alex Odama, the regional supervisor for TB and Leprosy in West Nile, urged schools to stop sending learners home over fees and instead prioritise health screenings. 

He announced that the TB screening exercise will resume next Tuesday using two mobile screening vans stationed in the counties of Maracha and Maracha East for two weeks.

Schools with TB Cases in Maracha

• Kololo Primary School (41 cases) 

• Offudee Primary School (26 cases)

• Galia Primary School (24 cases) 

• Andeni Primary School (11 cases) 

• Nigo Primary School (six cases) 

• Gbuluku, Kamadi and Cubiri Primary Schools  (three cases each) Maracha High School (three cases) 

• Maracha Secondary School (two cases)