Tuberculosis remains a major Public health threat in Ghana and Globally. According to the WHO report, TB it is the second leading infectious killer Globally after COVID 19. As an airborne disease TB anywhere is TB everywhere.
World TB day is a significant occasion for all health workers, partners, researchers, the TB community and all governments who contribute their resources to the fight against TB.
The Theme for this year’s commemoration is “Invest To End TB. Save Lives”
Ghana joins the rest of the world to commemorate World TB Day on March 24. This date was set aside to commemorate the day in 1882 when Dr. Robert Koch announced his discovery of Mycobacterium tuberculosis, the bacillus that causes tuberculosis (TB). The commemoration of World TB day is carried out annually in Ghana in March, with other programme activities carried out through the year. Activities carried out is intended to raise public awareness about the need to Invest in TB diagnostic tools (Genexpert, Xrays), TB research, TB Preventive Therapy, TB Advocacy against Stigma, It is estimated that each day, about 4,010 people lose their lives to TB across the world and 28,000 get infected as estimated by WHO.
TB burden estimate for Ghana (WHO 2021 Report)
Indicator | Number | Rate per 100k |
TB incidence | 44,000 | 143 |
Childhood TB | 4,400 | 14.7 |
HIV-positive TB incidence | 8100 | 26 |
HIV-negative TB mortality | 10,000 | 32 |
HIV-positive TB mortality | 4,900 | 16 |
TB mortality all | 14,900 | 48 |
Program achievement (2021 NTP report)
Indicator | Number (%) |
Total TB cases notified-New and relapse | 13332(30) |
Childhood TB cases notified | 645(4.8 out of the total notified cases.) |
Tested for HIV | 12632(95) |
HIV Positive TB | 1820 (14.4) |
Treatments Success | 86% |
The 2022 theme is, “Invest To End TB. Save Lives” – conveys the need for world leaders to understand that without adequate financial resources, we cannot win the fight against TB and reverse the severe impact of COVID-19. The disruptions caused by the pandemic have led to decreased the number of people diagnosed and treated for TB, and dangerously affected the rights of people with TB.
Current Programme Interventions to Increase TB case detection in Ghana
Bidirectional Testing
Currently, the programme is implementing Bidirectional testing. This intervention is aimed at picking samples for all coughs presumed to be COVID 19 cases and tested for TB. This stemmed from preliminary results from a pilot study in Greater Accra on testing for both COVID 19 and TB at the same time Yielded 9% COVID-19 positive and 13% TB positive.
TB Preventive Therapy (TPT)
Tuberculosis Preventive Therapy (TPT) is also high on the agenda of the National TB Program, which can significantly reduce the development of active TB among clients exposed to TB or who already have an inactive form of the infection. The program seeks to screen all contact of TB index cases and put eligible patients on TPT. TPT is a six (6) or three (3) months preventive Therapy contacts of index TB patients who test negative for TB. The treatment for TPT comes in a form of 6 months daily intake of Isoniazid or once a week intake of isoniazid and rifapentine for 3 months.
Equipment
The GeneXpert is a simplified real time PCR platform used as the initial diagnostic test for all newly presumed TB cases in Ghana. The machine has the advantage of being able to test for both first- and second-line drug resistance among patients and is relatively easy to use. The platforms were configured to test for COVID-19 during the pandemic and remains very useful for testing clinical cases across the country. There are currently 143 GeneXpert testing facilities in Ghana. The multi-disease GeneXpert platform is also used to test for the presence of HIV in early infant diagnosis (EID) as well as for HIV viral load
General Information about Tuberculosis
TB Disease
TB is transmitted from a sick TB patient as a droplet infection through coughing, singing and sneezing. Inhalation of these droplets by an uninfected person may cause infection. TB mostly affects the lungs, but can also affect other organs in the body such as the pleural cavity, liver, scrotum, kidney, intestine and womb. This is known as extrapulmonary tuberculosis. In addition, tuberculosis may also occur in animals such as cattle and this is referred to as bovine TB.
Symptoms of TB include Cough weight loss (poor weight gain in children), fever, tiredness, night sweats, chest pain. and cough with blood-stained sputum
Who Is at Risk
It must be emphasized that adults in most parts of the developing world including Ghana have been exposed to TB bacteria without knowing resulting in TB Infection. The progression from infection (latent TB) to active TB disease depends on the immunity of the individual. Those at higher risk of progressing to disease are: smokers, alcoholics, prisoners, people living in over-crowded and poorly ventilated rooms, mine workers or persons exposed to silica, and persons with lowered immunity due to medical conditions such as HIV, Diabetes, cancers, kidney failure and malnutrition.
However, TB is a preventable and curable disease. Diagnosis and treatment is available free of charge in all public and accredited private health facilities.
The Novel Virus – Corona has symptoms similar to Tuberculosis.
SIMILARITIES BETWEEN TB AND COVID-19 | |
Sign and Symptoms of TB | Signs & Symptoms of Corona |
Fever | Fever |
Cough (Productive) | Cough (Dry) |
Difficulty in Breathing | Difficulty in Breathing |
Fatigue, weight loss, chest pains, night sweat | Fatigue |
NB – Incubation period 12 weeks-up to years for TB whilst incubation period is 2-14 days for COVID-19.
Diagnosis
A person who visits a hospital or clinic with any disease condition is screened for cough. The patient who responds yes to cough is given a sputum container to produce sputum and sample is sent to the laboratory to be tested using GeneXpert technology. In areas where there are no Xpert machines onsite, samples are transported to a testing facility through a courier service. (Sputum Sample Transport) If the patient is tested positive, he/she is counselled and TB treatment commenced as soon as possible. In order to prevent loss to follow-up during treatment, home visits are done and family members are counseled to serve as treatment supporters. Household members including children under 5 years of age living in the household of bacteriologically confirmed TB patients (microscopic positive or GeneXpert positive) TB patients are screened for TB. If contacts are diagnosed with TB they will be treated for TB, if they are negative, they are put on TB preventive therapy (TPT).
Treatment
TB is cured with effective drugs using the Directly Observed Treatment (DOT) approach. The treatment regimen is for six months. Patients take their medications in their community under the supervision of a treatment supporter who could be a community health officer, a relative of the patient or a volunteer. This strategy is known as community-based TB care.
Note: A TB patient on effective treatment is less infectious after 2 weeks but still needs to cover their mouth. They must complete their treatment at 6 months to be completely cured.
Addressing Drug-Resistant TB
Drug resistant TB is detected whenever a TB patient’s sample is observed to have resistance to any of the first line TB medicines. Various types of drug resistance occurs such as mono and poly resistant TB. Most significant to the Programme is the occurrence of Rifampicin Resistance (resistance to Rifampicin alone or in combination with other medicines) and Multidrug Resistance (resistance to Isoniazid and Rifampicin together and in combination with other medicines).
Treatment of drug resistant TB is very difficult and expensive. Treatment lasts for 9-11 months Previously treatment included 8 months of Injection with serious side effects (hearing Loss) but now Injections have been faced out. Medicines cost up to 100 times more than first line medicines ($25 compared with $2,500)
Programme Challenges
- Low TB case detection
- Huge budget gap
- Stigma, myths and misconceptions about TB
Conclusion
The risk of TB in Ghana is high. TB anywhere is TB everywhere. We are all at risk. The good news is that TB is curable if we seek early treatment. Any person coughing for any duration with one or more TB symptoms report to the nearest health facility. We should try to avoid overcrowded rooms and ensure proper ventilation. TB patients should be encouraged to complete treatment rather than being ostracized.
AREAS OF DISCUSSION
- Why is the month of March set aside for Tuberculosis?
- The rationale behind the Theme, “Invest To End TB. Save Lives”
- What is the Area of Focus in TB in 2022
- Can Children be infected with TB?
- Is there any Protection to prevent TB? (TPT)
- Is TB a threat to society?
- How severe is the TB disease in Ghana
- What are some of the plights a TB patient goes through after diagnosis (especially from family, friends and society)
- How long does it take to treat TB?
- Is TB cured with Herbal medicines?
- What can the society and Government do to help find the missing TB cases as we inch towards 2030
- What have been some of the major challenges on TB management as a program and country?
The post TB control in Ghana ahead of commemoration of the 2022 World Tuberculosis Day [Article] appeared first on Citinewsroom - Comprehensive News in Ghana.
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