By Kemo Cham
Sierra Leone risks losing the fight to contain Tuberculosis or TBif adequate resources are not provided towards sensitization, officials and activists have warned.
Stigma and discrimination, among other factors, have plotted to keep TB sufferers away from treatment centers, threatening the country’s chance of ending transmission of the disease that is caused by bacteria, they said. Sierra Leone’s effort to end transmission of the disease has also been hindered by fears of multiple drug resistance, a phenomenon that further complicates treatment of the disease.
The warnings came as part of commemorations marking World Tuberculosis Day last week, March 24.
The World Health Organisation (WHO), which targets ending transmission of TB by 2030, used the day to call for increased funding towards TB control.
TB, an infectious bacterial disease caused by Mycobacterium tuberculosis, most commonly affects the lungs. The disease is transmitted from person to person via droplets from the throat and lungs of people with the active respiratory disease.
TB is a top infectious disease killer worldwide.Some 9 million people are thought to be infected annually across the world; and an average of 1.5m are said to be dying from it within the same period.
Over 95% of TB deaths occur in low- and middle-income countries, according to WHO, which also said the Africa region has the highest rate of cases.
WHO warns that the burden of TB is increasing in Sierra Leone. It estimates that the country has a prevalence rate of 574 cases per 100 000 population and said there were new “smear-positive” cases of 247 per 100 000 population.
Treatment of TB in Sierra Leone, like in many countries, is free of cost. But various factors have connived to keep patients away from treatment centers.
After a steady rise in treatment success rate between 2000 and 2009, Sierra Leone saw 79% reduction in 2010.The reasons for this include poor compliance of TB patients on treatment, unavailability of drugs for treating TB, and drug resistance.
The Ministry of Health and Sanitation (MoHS)said that at the end of last year there were 12, 103 cases of TB recorded in the country. And according to figures from the National Leprosy and Tuberculosis Control Programme (NLTCP), this represents a reduction of2897 cases, from the previous three years figure of 15, 000 cases.The NLTCP said the country attained an 88.1% cure rate, with the help of 170 service delivery points across the country.
“This is to say that Tuberculosis is both preventable and curable,” said Dr Lynda Foray, Manager of the NLTCP.
But some analysts have warned that this reduction in cases might have been as a result of under estimation.
For instance, the Ebola epidemic (2014 – 2015) also impacted treatment of TB as patients shunned centers thanks to lack of information and myths surrounding the viral disease.
According to the website www.worldlifeexpectancy.com, TB ranks second among the top 50 killer diseases in Sierra Leone, behind Influenza and pneumonia. The country is ranked No. 1 with the highest burden of TB cases, according to the site.
The Western Area, which include the capital Freetown, as well as the southern Bo District,are proving the most difficult in terms of cooperation by patients to take treatment, according to Health ministry of officials.
TB is also increasing because sufferers face stigmatization and discrimination and this has forced many people to deny having it.
Abdulai Abu Bakkarr Sesay, a TB survivor, lamented a prevalence of stigma and discrimination as a major deterrent. Sesay who contracted the disease in 2008 is Chairman of the Coalition of Civil Society for TB. He attributed the high rate of deaths to stigma and discrimination.
“The key point on TB is stigma and discrimination among the community members,” he said, boasting that he managed to survive by resisting stigma. He called for awareness-raising at community level so that people will be encouraged to seek treatment and ensure preventive measures.
Sierra Leone is also thought to have a 14% TB/HIV co-infection cases.
“This burden of the disease is serious enough to pose a significant threat to the social and economic development of any country unless concerted and effected measures are taken to combat the disease,” Dr Abu Bakarr Fofanah, Minister of Health and Sanitation, said in a statement marking the day.
He promised to ensure increase in diagnostic capacity of the country’s laboratories.
This year’s commemoration was held on the theme: “United to End Tuberculosis.”WHO is urging countries to adopt available newer tools to strengthen TB programmes.
The target set by the United Nations Sustainable Development Goals (SDGs) will be a challenge, but it can be done, said Mario Raviglione, Director of the world health agency’s Global TB Programme, in a report.
Globally, 30 countries are known to have the highest TB burden, and Sierra Leone is ranked among them.
Universal access to TB care and rapid testing for TB are key among measures identified for implementation.
(C) Politico 30/03/16
