FROM the Southern Highlands region of Mbeya there comes good news of national efforts to conquer Tuberculosis (TB), the world’s secondbiggest killer infectious disease, behind only HIV/AIDS.
Health experts, researchers and leaders of non-governmental organisations engaged in the anti-TB/HIV campaign are confident that it is possible to have a free TB generation by halving the treatment period from six to three months despite the disease being more expensive to detect.
Like elsewhere in Sub Saharan Africa, detection of TB in Tanzania has become more expensive because the nature of the epidemic has changed and requires newer diagnostic tools, health experts maintain. A Technology Officer based at the Mbeya Zonal TB Laboratory, Mjinja Samuel, says current tools used to diagnose TB include the age-old smear microscope which in some other African countries is said can no longer detect that kind of TB due to its changing nature.
The other diagnostic newer technology is called the Gene Xpert. In Tanzania, TB is no longer restricted to high risk population areas, but that it has spread across the country, increasing the chances of coming into contact with the disease.
“The situation and picture is quite different from the picture that we knew from three decades ago. Now TB is not restricted to high risks population but it is generalised, affecting every region, every district and every community,” says Dr Bonny Banda Ferdnands, the TB and Leprosy Coordinator of Mbeya City.
Last year, Mbeya Region recorded 3,400 TB cases with many of them from Mbeya City, Rungwe and Mbarali districts, according to Dr Ferdnands. With the use of 20 smear microscopes and six Gene Xpert machines in 33 laboratories, the region has seen improved TB detection in communities visited.
These communities include villages, 18 primary and secondary schools. “The message we have sent across to these communities is that ‘TB is a curable disease’ and that there are enough drugs in the treatment of identified patients,” said Dr Ferdnands.
Key organisations taking part in the National TB and Leprosy Programme (NTLP) in Mbeya Region include Africare, which has trained 160 community health workers to identify TB patients in villages in Mbeya and Songwe region.
Other organisations are ActionAid and Baylor Clinic which has helped identify 14 per cent of TB cases. Researchers at the staterun National Institute of Medical Research (NIMR)-Mbeya Medical Research Centre have since 2008 been making concerted efforts in collaboration with the National TB and Leprosy programme and other local and foreign institutions in seeking a cure to shorten the six-month TB treatment period.
“We have experts who can detect TB. These experts have been visiting districts to identify patients,” said Dr Issa Sabi, the Head of the TB Department at NIMR-MMRC. “We expect to launch a joint research on blood tests for children in collaboration with the University of London, Ghana, Mali, Gambia and Nigeria. It’s believed that there are many children who are afflicted by TB. That is why we plan to open a detection centre for children,” he said.
NIMR-MMRC Acting Director Dr Nyanda Elias Nitnginya said the thrust of his institution as far as TB research is concerned is capacity building in having skilled manpower for waging a relentless battle against the disease. “The aim of having a mobile laboratory is to visit hard to-reach areas in Mbeya Region,” he said.
Ruanda Hospital Resident Medical Officer In-charge at Mwanjelwa area, Dr Eliot John Sanga, said there was positive response from the community that TB can be prevented and cured. “Yes, there is stigmatization, but this attitude is a result of lack of education among the populace,” he explained.
Some TB patients interviewed at the Ruanda Hospital said sticking to treatment and medication procedures was of paramount importance in winning the battle against TB. “I had lost hope thinking I would die tomorrow. Howev er, after undergoing treatment, I can say with courage that TB is curable,” explained Joseph Mwangotwa, a patient diagnosed with chronic TB.
“I thank God that I can now walk. I could not manage to do that before I received treatment,” he said. TB is a bacterial infection, caused by Mycobacterium tuberculosis, which most often affects the lungs but can attack any part of the body, including the spinal cord and brain.
It is an infectious disease transmitted from person to person via airborne particles, which once inhaled can become the source of a new infection. Contrary to common misunderstanding, TB is not sexually transmissible. The World Health Organisation (WHO), estimates that round one in three people live with a latent TB infection, where the bacteria reside in the person’s body but are not transmissible and do not cause significant damage.
When a person’s immune system is compromised—for example, through infection with HIV, during cancer treatment, or in smokers—a latent TB infection can evolve into a fullblown case. The world body’s Stop TB Strategy, launched in 2006 with the aim to “dramatically reduce the global burden of TB,” concluded in 2015.
However, in terms of over all number of cases, there is still work to be done. In 2007, the WHO recorded 9.27 million new cases of TB, while in 2013, nine million fell ill with the disease (though the WHO does not specify if these were all new cases).
Another problem is the rise of multi drug-resistant (MDR) or extensively drug-resistant (XDR) strains of TB. The most common symptoms of TB are a persistent cough with blood in the sputum, as well as chest pains, general fatigue, fever, weight loss and night sweats.
Health officials advise that patients should see a doctor if they have a cough lasting more than three weeks or if they are coughing up blood. In Tanzania, great progress has been made in the fight against TB in recent decades under the National TB and Leprosy Programme through community education.
However, concerted efforts are still needed to mount a response commensurate with the scale of the problem. That needs to change – especially as we learn more about the interaction between TB and another deadly global killer: diabetes.
People with diabetes, say experts, are three times more likely to fall prey to TB. Diabetes can also make patients less responsive to standard TB therapies and elevate the chance of relapse after the disease has been treated. Two decades ago, TB and HIV/AIDS were paired in a similar deadly interplay.
AIDS, like diabetes, weakens the immune system, making its victims more susceptible to active TB. From 1990 to 2005, when HIV was infecting some two million people a year in SubSaharan Africa, the rate of new TB cases in the region quadrupled.