Taking health services to high risk populations

16 May, 2019 - 00:05 0 Views
Taking health services to high risk populations

The Chronicle

Tinashe Grateful Rufurwadzo

Miss Chido Moyo is a 29-year-old woman living with HIV. She has mastered the art of adherence and has been doing well on treatment from the time she knew about her HIV status. 

In February last year, she started to lose appetite and weight gradually. Little did she know that towards the end of 2017 when she was nursing her uncle who was diagnosed with Tuberculosis (TB), she had contracted the disease.

Never in her wildest dreams did she think she could endure the same fate, hence getting tested for TB was far from her mind.

“When I was growing up I was told to be conscious of TB if I started having a persistent cough. I never bothered to get tested for TB when I nursed my uncle because I wasn’t coughing,” said Miss Moyo.

In March 2018, she received an invitation from the community health care worker in her area to go for TB screening as a person living with HIV; one of the target populations. 

On the day of the screening exercise, in the company of a relative, she had an chest x-ray done and it showed that TB could be present although it was not clear. 

She was then asked to submit a sputum sample for GeneXpert (test to find TB bacteria) and she was diagnosed with TB. 

Miss Moyo was admitted into hospital for close monitoring during the initial phase of treatment. Two weeks down the line, she felt better, was discharged and continued with her treatment at home.

A follow up visit was conducted by the local staff from the community clinic six weeks after being diagnosed with TB and she was recovering well since starting treatment.

Her appetite greatly improved and she has started to gain weight. Miss Moyo started to receive her supply of medications from the local clinic. 

“I’m now able to walk and do some household chores which I struggled to do when I was ill, thanks to the timely mobile TB screening intervention brought in by FACT with support from its partners,” said Miss Moyo.

Since 2017, Family Aids Caring Trust (FACT) in collaboration with the Ministry of Health and Child Care (MoHCC) with financial support from the International Union Against Tuberculosis and Lung Diseases (The Union) through the United States Agency for Development (USAid), have been implementing the Targeted Screening for Tuberculosis (Tas4TB) project targeting; people living with HIV, contacts of TB patients, current or former miners (formal or informal miners), health care workers; diabetes patients, elderly (65+), prisoners and prison community, people living in refugee camps, and other congregate settings; people in poor overcrowded communities and smokers.

The project is being implemented in various districts in Zimbabwe not limited to Shamva, Guruve, Mutare, Matobo, Plumtree, Nkayi and Kwekwe among others.

Worldwide, tuberculosis (TB) is one of the top 10 causes of mortality. In 2017, 10 million people fell ill with TB, and 1,6 million died from the disease with a significant amount being people living with HIV. It cannot be refuted that TB is the leading cause of death among people living with HIV.

Globally, TB incidence is falling at about two percent per year. This needs to accelerate to a four to five percent annual decline to reach the 2020 milestones of the End TB Strategy. Ending the TB epidemic by 2030 is among the health targets of Sustainable Development Goals but this can only be achieved if health services are taken to high risk populations.

It is of paramount significance to note that Zimbabwe is the 17th highest TB burdened country in the world, and TB is the second leading cause of severe illness and mortality in Zimbabwe. The most significant contributing factor to the TB burden is the HIV and Aids epidemic.

Approximately 80 percent of TB patients are co-infected with HIV. This co-infection remains a major factor propelling the high death rate among TB patients in Zimbabwe. Over the last five years, the number of TB cases detected annually has ranged between 40 000 and 48 000.

African countries convened in Rwanda recently to deliberate on the possible achievement of Universal Health Coverage in Africa by 2030. The concept of Universal Health Coverage is about ensuring that all people and communities have access to quality health services where and when they need them, without facing any financial hardship.

In order to reach Universal Health Coverage by 2030, there is a need to continuously support screening for TB in high risk populations in an attempt to prevent transmission and disease progression through early diagnosis and initiation of appropriate care and treatment.

Among the high-risk populations, through active case finding, the TaS4TB project has managed to raise awareness, create demand, screen and initiate diagnosed clients on appropriate TB treatment without facing any financial hardship. So far, under Tas4TB, FACT has screened 86 300 clients and of these 1 300 were diagnosed with TB and initiated on appropriate treatment.

*Tinashe Grateful Rufurwadzo is the Documentation and Communication Officer at Family Aids Caring Trust. He can be contacted via email [email protected] 

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