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Fighting TB from all fronts

HANDY IN TB FIGHT – Sputum collecting centres (above) and mobile vans

By Mphatso Nkuonera:

HANDY IN TB FIGHT – Sputum collecting centres (above) and mobile vans

When he picked up a job as a laboratory technician at Mzuzu Central Hospital few years ago, Ian Kambwani’s celebratory mood was short-lived.

He realised that he had to work in risky conditions that exposed him to diseases like tuberculosis (TB). The room he operated from did not have any scientific protective measures despite TB being an airborne disease.

But now he feels safe following the expansion of offices and the installation of ultraviolet germicidal (UVG) lights used to kill or inactivate microorganisms, thanks to Global Fund.

“The offices are spacious and complete with UGV lights which kill bacteria that cause TB, making the working premises free from TB transmission,” he says.

Kambwani recalls that before the installation, it was also difficult to work in a tiny room filled with machines and cartons of medical materials.

He could also just test few sputum specimens.

The numbers have gradually swelled up because Global Fund also provided modern machines that facilitate rapid tests.

Ministry of Health spokesperson Joshua Malango says the institution has from 2003 provided four mobile vans, medical items, TB drugs, malaria, HIV and Aids and drug storage facilities nationwide.

“We have four mobile vans to help in mobility and bring clinical services to those living in hard-to-reach areas,” Malango says.

Mzimba North District Health and Social Services Officer, Emily Gama, says the mobile clinic vans have led to an increase in the number of people that seek TB tests.

Gama says there is a direct connection between the presence of the mobile clinic vans and the number of people to be screened for TB and patients on treatment.

“Since the coming in of the mobile vans here, we have seen that the number of people screened per day and those put on treatment has increased.

“The presence of the mobile clinic vans gives us the opportunity to take early assessments of TB signs from their homes through special sputum collecting points in various communities,” Gama adds.

Mzimba North alone received 3,000 people between March 2018 and June 2019. Seventy-four of them were diagnosed with the bacterial infection that attacks the lungs.

“We now have an improved TB notification rate. In addition, patients are able to follow treatment guidelines well because these mobile vans regularly visit the sputum collections points to administer drugs to patients while continuing testing others.

“We are excited because no health worker is getting infected with TB from patients unlike in the past when many workers contracted the disease,” Gama says.

She, however, wants to see more clinical officers trained in diagnosis and more microscopic centres opened to accelerate the testing process.

Mchinji District Assistant TB Officer Alex Mphalaso says Global Fund trained health workers and donated a motorcycle to facilitate mobility from sputum collection points to the hospital.

“From 2009, mobility was the biggest challenge and TB treatment defaulting was very high. Now, the motorcycle has led to early detection of TB cases and patients are put on treatment on time.

“For example, in 2018, we detected 266 cases while by September 2019, we had 395 cases. The figures are likely to increase,” Mphalaso explains.

At Mangochi District Hospital, mobile van coordinator Esnart Chikhawo says more men than women come to test for the airborne infection.

Chikhawo is, however, appealing for more mobile vans, saying the one the facility uses is overstretched and fails to reach some hard-to-reach areas.

She adds that the sputum collection points have also assisted in the early detection of diabetes, hypertension and cervical cancer.

“We take advantage of our interaction with people to advise them to visit hospitals when we notice signs of other diseases,” Chikhawo says.

Meanwhile, communities of Mtambo Village in the lakeshore district have instituted TB fighting groups at village level to help in monitoring those taking drugs and mobilising others to go for TB testing.

Apparently, efforts of the groups are already bearing results as they have convinced some ‘very stubborn people’ to go for screening.

Laboratory Manager at Community Health Science Unit, Mirriam Nyenje, says TB diagnosis and treatment has improved tremendously because of the Global Fund donations of testing machines and medication.

“We now have 375 microscopes across the country. TB is now manageable unlike in the past when all sputum samples across the country had to be tested here. It could take eight weeks to release results. But now it only takes 42 days,” Nyenje says.

National TB Control Programme Manager, James Mpunga, says through decentralisation, diagnostic centres have increased from 74 to 372.

He says Malawi is winning the TB fight as World Health Organisation recommendations are that 90 percent of patients on treatment must be cured and that the country is at 88 percent.

“We have reduced new cases to 131 from every 100,000 people and, as we go towards 2025, we will be very good,” he says.—Mana

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