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TB still remains one of humanity's scourges

By Moses Walubiri

Added 18th March 2019 01:29 PM

According to Ministry of Health data, TB is four times more prevalent among men than women and the rate higher among urban slum dwellers.

TB still remains one of humanity's scourges

According to Ministry of Health data, TB is four times more prevalent among men than women and the rate higher among urban slum dwellers.

Apart from HIV/AIDS and the bubonic plague that claimed millions of lives in some parts of Europe during the dark ages - wiping out entire settlements in some instances, few diseases have sent ripples of fear down the spine of humanity like Tuberculosis (TB).

Uganda joined the rest of humanity to mark the World Tuberculosis Day on Sunday events offer an opportunity to reflect on a disease that still remains one of the major causes of death in some corners of the globe.

On 24th March, 1882, Dr. Robert Koch, then a leading light in research on TB, astounded the scientific community when he announced that he had discovered the cause of Tuberculosis, the TB Bacillus.

At the time, TB was the leading cause of death in Europe, claiming the life of one out of every seven people.

In 1982, a hundred years after Koch's eureka moment,   the International Union Against Tuberculosis and Lung Disease agreed that 24th March  be proclaimed as an official world TB day.

This year's international theme: "it's time," is pregnant with meaning and resonates with the current efforts by stakeholders to put awareness and treatment of TB high on the agenda of Governments' priorities.

The theme in Uganda, according to Dr. Stavia Turyahabwe, the acting Assistant Commissioner TB and Leprosy, is: "Its time for Uganda to end TB. It starts with me."

"It's very possible to have a future free TB in Uganda. But this calls for all stakeholders to walk the talk and responsibility on the part of Ugandans through embracing free screening at all government health facilities at the level of Health Center three," Turyahabwe said during an interview with New Vision.

To realise the dream of a Uganda without TB as envisaged in this year's theme, Turyahabwe agrees that there  is a need to embrace a multipronged approach involving reduction of the rate of new infections, screening and treating the sick.

According to Turyahabwe, TB prevalence in Uganda is 253 per 100,000 people with an estimated 86,000 new infections recorded every year.

This rate (incidence) of infection translates into 201 per 100,000 people.

Concerning areas and segments of Uganda's society that are worst affected, Turyahabwe contends that the risk groups in Uganda include people living with HIV, camps and settlement dwellers living in insalubrious conditions, with little or no ventilation.

According to Ministry of Health data, TB is four times more prevalent among men than women and the rate higher among urban slum dwellers.

"You see, TB is airborne and conditions prevalent in slums where houses are hardly ventilated and yet crowded make transmission of the disease easier," Turyahabwe said.  

Areas in Cattle corridors like Nakasongola and Karamoja, Turyahabwe revealed have a high prevalence of TB through eating unprocessed animal products.

As for the men having a higher TB incidence than woman, the commissioner puts it down to the diametrically opposed lifestyles of the two sexes.

One of them is smoking which is more common among men than women. Smoking damages the lungs and this, according to Turyahabwe, makes it easy for TB to spread.

Another cause is that it's easier to find men in crowded places like prison and bars which exposes them to TB.

Regarding multidrug resistant TB variant, the commissioner concedes it's a "concern". Drug resistant TB variant is transmitted like other types of TB only that it develops mechanisms to undercut the efficacy of the line of drugs that treat TB.

The challenge pertaining to drug resistant TB variants is that while it takes only six months to treat the ordinary type, a patient will have to undergo treatment for more than one year.

Sometimes, Turyahabwe revealed, treatment can go on for a year and there is need to use injections every day for these TB patients.

The commissioner warned that people who start the normal TB treatment but fail to complete their treatment have a 12% chance of contracting drug resistant TB variants than other TB patients.

Currently, slightly more than 2% of TB patients in Uganda have drug resistant TB strain.  

Ministry of Health has adopted a proactive policy regarding TB screening which allows health personnel to reach out to family members of those diagnosed with the disease.  

If a husband, for example, is diagnosed with TB, medical personnel go to his home to screen his wife and children to ascertain whether they are TB free.

"TB diagnosis and treatment is free. The good news is that TB is curable so long as the patient completes treatment," Turyahabwe said.

Outside Lebanon and Turkey, Uganda with over 1.1m refugees, no other country is hosting more people escaping conflicts anywhere in the world.

Turyahabwe concedes that refugees pose a challenge because many come from countries whose health sectors are broken.

Many of these, she contends, come to Uganda with undiagnosed TB while others have drug resistant variants of TB.

This, she avers, explains why in communities hosting refugees like Hoima and West Nile, the TB incidence is higher which puts a strain on available health facilities.  

MoH, Dr. Jane Ruth Aceng has appealed to Ugandans to be vigilant in responding to the interventions the ministry is implementing to reduce the TB burden in the country.

"The 86,000 new infections every year are really on the high. TB is treatable and curable. Its only when patients fail get diagnosed and treated early that they eventually die," Aceng said.

 Only by being Vigilant, Aceng contends, will the dream of a TB free Uganda become a reality.

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