A new 2013 world report on Tuberculosis shows that Uganda has remained off track in fighting the diseases after it registered 44,300 new cases in 2012. Out of the 22 High Burden Countries, 16 reached or exceeded the 85 per cent target in 2011, including Ethiopia and Nigeria for the first time.
Uganda, however, reported lower rates of treatment success at 71 per cent, missing the target of 85 per cent once again, showing stagnation from 2011’s 71 per cent. On a positive side, Uganda exceeded the 90 per cent target of enrolling HIV-positive TB patients on treatment in the same period.
Other countries that exceeded the target on treating HIV Positive TB patients in 2012 include Angola, Botswana, Burkina Faso, Burundi, Cambodia, India, Kenya, Lesotho, Mozambique, Namibia, Rwanda, Swaziland, Tanzania and Zambia.
Dr Frank Mugabi, the commissioner in charge of TB and Leprosy Programme attributed the lag to lack of awareness among communities, lack of functional treatment support systems and failure by patients to adhere to treatment.
He also said that the country does not have enough diagnostic equipment – the gene expert machines that are being used for early detection of the disease.
Lack of diagnostic equipment
“Ideally, every general hospital and HIV/Aids clinic should have this equipment. But we have a very huge gap for diagnosis. Treatment cannot be done if we are not able to diagnose the disease,” he said adding that, nearly 20,000 cases of TB were missed due to lack of such equipment.
Dr Mario Raviglione, the WHO director of the Global TB Programme, said, “far too many people are still missing out on such care and are suffering as a result. They are not diagnosed, or not treated, nor is the information on the quality of care they receive.”
WHO estimates that 75 per cent of the three million missed cases are in 12 high burden countries where Uganda falls. While the number of people detected worldwide with rapid diagnostic tests increased by more than 40 per cent in 2012, the report shows that three out of four Multi Drug Resistance –TB (MDR-TB) cases have remained without a diagnosis.
Those reported have not yet been put on treatment. “The unmet demand for a full-scale and quality response to multidrug-resistant tuberculosis is a real public health crisis. It is unacceptable that increased access to diagnosis is not being matched by increased access to MDR-TB care. We have patients diagnosed but not enough drug supplies or trained people to treat them. The alert on antimicrobial resistance has been sounded; now is the time to act to halt drug-resistant TB,”says Dr Raviglione.
To address this, the WHO report has recommended the 3 million TB cases missed in national notification systems be reached by 2015.