We have to scale up efforts to fight against TB in Africa

27Nov 2020
The Guardian
We have to scale up efforts to fight against TB in Africa

Tuberculosis (TB) is an infectious disease usually caused by  bacteria.  Tuberculosis generally affects the lungs, but can also affect other parts of the body.  Most infections show no symptoms, in which case it is known as latent tuberculosis.  About 10 per cent of latent infections progress-

-to active disease which, if left untreated, kills about half of those affected.  The classic symptoms of active TB are a chronic cough with blood-containing mucus, fever, night sweats, and weight loss.

Tuberculosis is spread through the air when people who have active TB in their lungs cough, spit, speak, or sneeze.  People with latent TB do not spread the disease.  Active infection occurs more often in people with HIV/AIDS and in those who smoke. Diagnosis of active TB is based on chest X-rays, as well as microscopic examination and culture of body fluids

A total of 1.5 million people died from TB in 2018  including 251 000 people with HIV   worldwide. TB is one of the top 10 causes of death and the leading cause from a single infectious agent  above HIV/AIDS .

Tuberculosis incidence in Tanzania has gone up from 62,908 new cases recorded in 2015 to 82,166 being  attended to at present, partially because testing has been enhanced.

This assessment was made by the Chief Medical Officer, Prof Abel Makubi, when opening the National Tuberculosis and Leprosy Programme annual meeting recently.  According to him  fatalities from the infectious bacterial disease declined from 30,000 in 2015 to 20,000 deaths recorded this year, largely due to early treatment.

“Since 2015, the lives of over 300,000 patients, including 45,000 with mild symptoms, have been saved because of early detection and treatment,” he said.

Prof Makubi said enhanced detection and early treatment were possible because of implementation of TB control strategies of the National Tuberculosis and Leprosy Programme.

The strategies include mass testing targeting at-risk groups such as households with patients, prisoners, artisanal miners, drug users and people living in congested settlements, he affirmed.

“We have also invested in new molecular techniques for easier and more accurate diagnosis of TB,” he elaborated.

Dr Leonard Subi, the director of Preventive Services said the Ministry of Health, Community Development, Gender, Elderly and Children has achieved its objectives set out in the TB control strategy that ends this year.

“These numbers show that we have reached our death reduction target as well as the burden of the disease in the country,” he said, pointing out that the government increased diagnosis centres for chronic TB from just one facility in 2015 to 145 at present.

The World Health Organisation Global TB Report 2019 showed that incidence and deaths have been falling relatively fast in the WHO African Region (4.1 per cent and 5.6 per cent, respectively, per year), with cumulative reductions of 12 per cent for incidence and 16 per cent for deaths between 2015 and 2018.

Seven high TB burden countries including Tanzania were on track to achieve the 2020 milestones in the fight against TB. Others are Kenya, Lesotho, Myanmar, the Russian Federation, South Africa and Zimbabwe, the agency noted.

The milestones for 2020 were a 35 per cent reduction in the number of TB deaths and a 20 per cent reduction in the TB incidence rate, with the 2020 milestone requiring that no TB patients and their households face catastrophic costs as a result of the disease.

“The End TB Strategy milestones for 2020 and 2025 can only be achieved if TB diagnosis, treatment and prevention services are provided within the context of progress towards universal health coverage (UHC),” the report stated. This is possible if there is multisectoral action to address the broader determinants that influence TB epidemics and their socioeconomic impact, it added.