TB prevalence rises by 60% in Uganda - survey

29 August 2017 - The number of Ugandans living with tuberculosis (TB) has gone up by 60%, a new survey has found, indicating a worrying spread of the deadly bacterial infection.

TB is a bacterial infection that attacks the lungs; acquired through droplets from the coughs or sneezes of an infected person. It is one of the top 10 causes of death worldwide.

The standard symptoms of TB infection include chronic cough with sputum containing blood, fever, night sweats and drastic weight loss.

A new survey has found that the prevalence is far higher than previously thought, with the number of people living with the infection almost twice the figure hardly two years ago.

According to the survey, whose partial findings were unveiled Monday, TB prevalence in Uganda now stands at 253 per 100,000 people, compared to 159 per 100,000 in 2015.

The study was carried out by the World Health Organization (WHO) and Global Fund, in partnership with the Ministry of Health National Tuberculosis and Leprosy Program and several partners.

The survey was carried out over a two-year period from 2014 and 2015 and examined a total of 41,156 people from 57 districts.

A total of 5,144 participants (12.5% of the sample) showed signs and symptoms of TB infection and had to undergo further tests.

The participants were screened using a combined TB symptoms check and chest x-ray. The survey was meant to assess the burden of TB and identify ways of improving TB control in the country.

Men face higher risk

There are four times more men than women living with TB, the survey reveals, and the highest burden was found to be among people aged between 35 and 44.

An estimated 89,000 people get TB disease per year, the survey shows but almost half (41,000) of all cases go undetected, exposing more people to infection since they are less inclined to seek treatment.

Undetected cases are highest in the 15-24 age group and the burden of TB was found to be higher in urban areas (504 per 100,000 persons) than rural in areas (370 per 100,000 persons).

A significant number (39%) of individuals with TB symptoms do not seek treatment, highlighting a worrying health-seeking behavior, researchers stated.

Co-infection is a key concern as 27% of TB patients are HIV positive. The number of new TB cases is due to surpass that for HIV which have seen a steady decline from 140,000 cases in 2013 to 99,000 in 2014.

Dr. Frank Mugabe, the head of the National TB and Leprosy Program (NTLP) told New Vision yesterday that government was adopting a cure-to-treat approach to deal with the rising new infections.

“When you cure one TB patient, you will have prevented infection for 10 to 15 patients,” he explained, revealing that most at risk populations would be given doses to prevent infection.

The booster doses will be given to people living with HIV, prisoners, children under the age of five and those with low immunity, who are rated as most-at-risk group.

The study advocates for investment in x-ray as a screening tool for TB and calls for a ‘deliberate shift’ from microscopy as the primary diagnostic tool to more advanced tools including GeneXpert.

It also recommends increased funding for TB response plan, expansion of TB screening services, human resources, involvement of the private sector to support TB care, and public awareness.

Dr Mugabe said government would roll out a ‘systematic screening model’ where one person tests positive for TB and all the people who have come into contact with him or her are screened too.

Special programmes

For young people, Dr Mugabe said adolescent friendly initiatives and joint TB, HIV and STIs programmes would be introduced to raise awareness and encourage them to seek treatment.

In order to improve treatment outcomes and help cut TB transmission rates, health experts are looking at addressing the treatment aspect.

Starting in January, adult patients suffering from multi drug resistant TB will take a shorter dose lasting nine months instead of 24. A standard dose for children suffering from regular TB takes six months.

Effective November, children (14 years and below) living with TB will be enrolled onto a much more effective drug that is dispersible and sweetened to make it tolerant.

High burden

Uganda is one of the 22 high TB burden countries in the world. The country registers about 5,000 TB-related deaths a year.

The WHO estimates that two billion people (one third of the world's population) are infected with the bacteria that causes TB.

In 2015, 1.8 million people died from TB while 10.4 million fell ill from it. The infection is linked to a cycle of poverty in affected families, communities and even entire countries.

Source: New Vision