clinician carries out TB testing at a health centre in Lilongwe

Last Thursday was the World Tuberculosis (TB) Day set aside to raise awareness about the disease. Our Staff Reporter LLOYD CHITSULO writes:

TB is a curable deadly disease that mostly affects the lungs. According to the World Health Organisation, it claims over 4 100 lives and attacks nearly 28 000 people every day.

Since 1986, TB has become a top killer of Malawians living with HIV, especially those who delay or default treatment.

However, Ministry of Health principal secretary Charles Mwansambo says the disease burden has been declining at the rate of two to three percent for the past six years. He adds that the treatment success rate for all forms of TB has increased from 82 percent in 2015 to 89 percent in 2020.

“The government and its partners are committed to meeting expectations of its people and that of the international community, including the UN high-level meeting target to end TB by 2030,” he states.

Mwansambo says the country has ramped up community-led initiatives to increase detection of persons with TB and put them on effective treatment. This includes efforts to strengthen the capacity to diagnose TB among children.

In 2020, the Ministry of Health treated at least 15 000 TB patients and over 1 200 deaths.

A nationwide survey in 2014 revealed that 334 people out of 100 000 develop active TB each year.

The survey showed that the burden is higher in urban areas than in rural areas, with men disproportionately affected.

Health and Rights Education Programme executive director Maziko Matemba says while TB management has improved with donor support, there is a need to expand testing so than no one is left behind.

“A lot needs to be done to improve testing at the community level and identification of missing cases. More needs to be done to improve notification by providing hi-tech equipment in all public health facilities,” he says.

The community health activist says the commitment to eradicating TB in the current decade will not be achieved unless the country tackles multi-drug resistance TB.

The WHO targets to diagnose and treat 40 million people with TB by 2022. These include 3.5 million children and 1.5 million people with drug-resistant TB.

The UN health agency further targets to reach 30 million people with TB preventive treatment by 2022, especially those most at risk receive TB. The target vulnerable community includes 24 million household contacts of TB patients, four million of whom are children aged below five and 6 million people living with HIV.

Public health emergency specialist Adamson Muula, from Kamuzu University of Health Sciences (Kuhes), says the TB programme has been well-run for decades.

He says: “The programme has had strong leadership and relied on solid data and research on what they have been doing. TB increased exponentially in the 1990s as a result of HIV.

“But with the reduction in HIV cases and a robust ARV programme, TB has gone down. Even when an individual has HIV, their risk of TB is way so small when they are on ARVs.”

Muula further says the government’s screening programme continues to mature and that using gene-expert technology has revolutionise TB diagnosis in the country.

Apart from that, Muula says there are available effective medicines that if taken according to guidelines result in high cure rates.

“Working together with communities, development partners and non-governmental organisations, Malawi has succeeded where other countries are struggling. Malawi has also consistently received Global Fund and World Bank funds to fight TB,” says Muula.

In the wake of Covid-19, health experts fear that gains made in the fight against TB will be eroded since the focus has been shifted to controlling the pandemic discovered in December 2019.

The Ministry of Health reports a reduction in the number of people seeking TB diagnostic and treatment services following the emergence of Covid-19 and its control measures.

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