Limited awareness, stigma hampering efforts to treat TB – Chilufya

HEALTH minister Dr Chitalu Chilufya says limited awareness about TB and stigma associated with the disease are the principal factors hampering government efforts in finding and treating all patients countrywide. During commemoration of this year’s World Tuberculosis (TB) Day which falls on March 24, Dr Chilufya said TB, a preventable and curable disease, remains one of the major causes of ill-heath and deaths in Zambia.

He said this year’s World TB Day was commemorated under the theme ‘It’s time! Kick out TB’, which resonates well with the government’s agenda of eliminating the disease by 2030. Dr Chilufya said the World Health Organisation estimates that every year there are 62,000 people who fall ill with TB in Zambia.

“Unfortunately, out of these, over 25,000 TB cases are not detected and treated and therefore continue to transmit the infection to others in the community. In Zambia about 18,000 lives are lost annually due to TB despite having free TB tests and treatment for all people living in Zambia. While people dying of TB is unacceptable, what is equally deplorable is its negative social-economic impact on individuals, families, communities and the country,” he said.

He said limited awareness about TB and stigma associated with the disease were the principal factors hampering government efforts to finding and treating all TB patients countrywide.

“This is why for this year’s World TB Day, we are enlisting pupils and students in the primary, secondary, colleges and universities as ambassadors of this TB awareness campaign because it is known that children and adolescents are excellent in carrying right messages to their parents and communities. In this way we are also assured that this population will grow up knowing how to prevent TB, thus making the goal of eliminating TB in Zambia a reality,” he said.

Dr Chilufya said TB was preventable and curable but people with a cough, night sweats, fever, chest pains and weight loss – the cardinal symptoms of TB – often do not take action because of limited awareness about the disease.

“They come to the clinic when they are very sick, making it difficult to cure the disease. Sometimes, people know these symptoms but are terrified or feel that they will be judged by others for having TB. Stigma is still widespread in our communities and we all have a vital role to play in ensuring that we get rid of stigma for all diseases, especially TB and HIV. I am calling upon pupils, students, our traditional leaders, religious leaders and civic leaders to take action by raising awareness about TB in our communities. It’s time we say no to TB stigma and discrimination,” he said.

He said this year’s World TB day was unique because it comes barely five months after the first ever United Nations High Level Meeting on the Fight Against TB that was held in September 2018 in New York-United States of America. At this meeting, Heads of State, World Leaders, Civic Leaders, Members of Parliament and Civil Society Organisations committed to double their efforts in the fight against TB.

“His Excellency, Mr Edgar Chagwa Lungu, President of the Republic of Zambia led the Zambian delegation at this high-level meeting. The global leaders unanimously agreed on the targets necessary to give a momentum to ending TB in the world. In line with the United Nations high-level meeting resolutions we are gathered here to tell the whole nation that it’s time: to raise awareness about TB, to step up the fight to end TB in Zambia, to keep the promise to end TB in Zambia, to know our TB status, to stop TB deaths, to put people first in our TB response,” he said.

Dr Chilufya said his ministry had embarked on a transformation agenda anchored on primary health care that includes bringing TB services as close to people’s homes as possible.

“Our goal as a government is to establish resilient and robust health systems that prioritise the provision of high-quality TB prevention, care and treatment services. In our transformation agenda, that is being championed by His Excellency Mr Edgar Chagwa Lungu, President of the Republic of Zambia, we place emphasis on not leaving anyone behind and ensure that everyone living in Zambia has easy access to health services including TB prevention, care and treatment services. The Ministry of Health continues to prioritise preventive health services, and ensure that those who fall through the cracks of our preventative measures are provided high quality care and treatment,” he said.

He said Zambia was on the right trajectory towards TB elimination.

“In the past 18 years we have managed to reduce TB incidence rate from 759/100,000 in 2000 to 361/100,000 in 2018 representing over 50 per cent reduction. The TB incidence continues to drop by 4 to 6 per cent annually, though below the desired 10 per cent annual reduction if we are to attain our goal of Eliminating TB by 2030. Out of all the TB patients we put on anti-TB treatment, we are curing as high as 90 per cent. Further, we have scaled-up a network of rapid TB diagnostic tools and enhanced linkage to care for TB treatment. We now have in excess of 210 GeneXpert machines, which are a state-of-art equipment that give a result within 2 hours, countrywide. Beside these GeneXpert machines, we have other TB rapid molecular diagnostic tools that are able to detect other forms of TB such extensively drug resistant TB (XDR TB). Our health personnel are now more alert to diagnose TB and treat it successfully,” Dr Chilufya explained. “With this capacity, we have increased our detection rate of drug resistant TB by over 45 per cent from 270 cases in 2017 to 507 cases in 2018. In turn, our treatment success of drug resistant TB has improved from 33 per cent in 2013 to 71 per cent in 2018 standing above global Drug resistant TB success rate. With these success stories we are on the right path towards eliminating TB in Zambia. For these successes our health care workers and the community deserve special accolades.”

He said every client that comes to the health facilities should be screened for TB and put on treatment if found with TB.

Dr Chilufya said for individuals at risk of developing active TB such as people living with HIV (PLHIV), they should be put on TB preventive treatment (TPT).

“I would like to underscore that TPT has been proven to prevent deaths due to TB in PLHIV by nearly 40 per cent. As a nation, we have made significant progress in the fight against HIV/AIDS. We are aware of where we are coming from. It is gratifying that we have turned the tide on HIV/AIDS being previously perceived as a death sentence. HIV/AIDS is now a treatable chronic disease. It has become obvious that our gains in the fight against HIV/AIDS may be lost due to the high deaths in this population which are attributable to TB. It has been established that 72 per cent of TB deaths are in people living with HIV. This calls for us to respond to the TB epidemic with great speed and on a large scale. The TB and HIV programmes need to work closely and ensure no one dies from TB,” he said. “We have a basis to say it is possible to achieve zero TB deaths because TB is preventable, TB is curable. People are dying from TB due to lack of awareness, late presentation to health facilities. We have the means to prevent and cure TB.”

He expressed gratitude to cooperating partners and civil society organisations who have always partnered with the government in the fight against TB.

Dr Chilufya said it was time to intensify awareness about TB and put an end to the stigma associated with the disease.

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