Need for male involvement to track missing TB cases

Patients wait in the queue to get treatment at at a Gulu hospital TB ward last year. File photo

What you need to know:

This year, Uganda adopted the global theme “United to end TB”; find the missing cases and it requires increasing our efforts to detect and treat those exposed to the disease

Currently, there are 41,161 missing Tuberculosis (TB) cases in the country and of these, 27,441 are men. As Uganda joined the rest of the word to mark the World TB day on Friday last week under the theme, United to end TB, they also had a slogan, find the missing patients with TB.

Speaking at the TB Symposium 2017 Kampala, Samuel Kasozi the deputy chief of party, Management Sciences for Health, said the reason they are focusing on finding the missing cases is because when these people are out there and are not on treatment, they continue to spread TB.

“We all know that any case left untreated for a year continues to transmit between 10 to 50 new cases. So if we are not finding new cases, we are allowing TB to continue spreading in the community at a rate we cannot control.”

Kasozi added that since most of the missing cases are of men, there is need to change interventions towards the fight against TB. He explains, “Statistics show that it is mainly the female patients who seek medical services so it becomes impossible to trace such missing cases. However, government needs to come up with an intervention that will see men getting on board and taking part in reporting cases of TB.”

Causes of the missed cases
According to reports from Advocacy for Better Health (ABH), a major reason that contributes to missing cases is poor health-seeking behaviour of those reporting chronic cough.

“About 39 per cent of symptomatic presumptive TB patients and 36.7 per cent of symptomatic prevalent TB cases did not take any action for their symptoms. The reasons for not seeking care included ignored illness (31.1 per cent), self-treated (31 per cent), hindered by cost (16 per cent), did not recognise illness (12 per cent), long distance (5.4 per cent), long waiting time (1.3 per cent) and others (2.9 per cent).”

The report adds that use of poor TB diagnostic services contributes to missed TB cases.

However, Dr Jane Ruth Aceng, the minister for Health, said the ministry is going to revive the male involvement strategy that was launched two years ago to ensure that they track the missing male cases.
‘We also have male teams who have been trained to reach out to those in the communities but we need to give them information about the effects of them having TB,” she added.

Meanwhile, speaking at the same event, the US Embassy, Charge d’Affaires, Colette Marcellin called upon government to dedicate more resources and attention to the fight against TB if issues of missing cases are to be adressed.

She said the current budget for the National TB programme covers only four per cent of Uganda’s needs to combat TB; 76 per cent is funded through external resources and 20 per cent remains unfunded.

“While the United States remains committed to working with the government to end TB, this programme cannot achieve the common goal of ending this epidemic with such a large funding gap, high donor dependency, and limited domestic financing.”

Things you need to know about TB

Usually, TB attacks the lungs but other organs such as the brain or the kidneys can fall prey to the disease too. Here are other facts you did not know

1. HIV patients are at risk
According to experts, the probability of the disease is higher in HIV patients, as their immune system is weaker than others. Most HIV deaths occur due to TB.

2. It is an air-pollution borne disease.
City pollution is one of the major causes of tuberculosis. Stray dust on roads as well as fine dirt particles from construction sites can enter your lungs and aggravate chances of tuberculosis.

3. TB spreads by air.
Tuberculosis can spread by being in the infectious air as the disease is an infectious one whose bacteria travel through air droplets, by way of coughing or sneezing by an infected person. Therefore, a person who is infected should always avoid crowded, closed spaces and shift to an open environment immediately.

4. You might have TB and not know it.
According to statistics, about 2.3 billion people in the world have TB, but many may never know that they have it. Due to a condition called latent tuberculosis, the person infected might never experience severe symptoms or be hazardous to others, but the germs will simply stay in the body.

5. But fret not, you can fight it.
However, in only 5-10 per cent of people does the TB bacteria become industrious. These people can spread the disease to other people as the bacteria is active.

6. TB is mostly found in under-developed nations.
Mostly, TB is found in underdeveloped countries, especially in the Africa, Asia, Latin America, or Russia regions. Close to 1.5 million people die from the disease every year. TB is found to be very common in shelters for homeless people, prisons, hospitals and nursing homes, immigration settlements, etc.

7. TB can affect more than just your lungs.

9. I have TB, what do I do now?
In case you have tuberculosis, you should stop tobacco and alcohol intake immediately, lessen caffeine consumption, decrease eating refined food items such as white rice, sugar, white bread, etc., avoid red meat or other cholesterol inducing items. You should also visit a doctor immediately.

10. What to eat, what to stay away from.
What you should eat, however, are poultry products, fish, wheat-based products, dark-green vegetables such as kale, spinach, beans, broccoli and the like, vegetables naturally occurring in bright colours, such as carrots, bell peppers, tomatoes and fruits such as blueberries, cherries, etc., as these are rich in anti-oxidants.