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Covid-19 disrupts TB address progress

by Staff reporter
25 Mar 2021 at 05:45hrs | Views
BULAWAYO, Midlands, Matabeleland North and South provinces accounted for most tuberculosis (TB) deaths recorded in Zimbabwe last year amid reports that Covid-19 disrupted progress that Zimbabwe had made in addressing the killer disease.

This came out during the World Tuberculosis Day commemorations yesterday when the country joined the world in lobbying for increased efforts to end TB.

Each year, World TB Day is commemorated on March 24 to raise public awareness on the devastating health, social and economic consequences of TB, and to step up efforts to end the epidemic.

This year's theme "The Clock is Ticking" conveys the sense that the world is running out of time to act on the commitments to end TB made by global leaders at the first-ever UN General Assembly High Level Meeting on TB conducted on September 28 in 2018.

The 2019 WHO Global TB report says Zimbabwe is listed among the 30 high-burdened countries for TB, TB/HIV and MDR-TB for the period 2016-2020.

In Zimbabwe, it is estimated that 29 000 fell ill of TB in 2019 and about 6 300 of these succumbed to the disease. 1 200 of those diagnosed TB cases had drug-resistant TB. Women of the reproductive age group (15-44 years) and men are mostly affected. The TB incidence rate was 199 per 100 000 population in 2019.

In his keynote address, the Vice-President and Minister of Health and Child Care, Dr Constatino Chiwenga said a number of TB cases were missed last year due to Covid-19 which greatly affected access to health care.

"Zimbabwe, along with the rest of the world, agreed on an ambitious and powerful political declaration to accelerate progress towards End TB targets. The emergence of Covid-19 in 2020 has disrupted the progress in our National TB response as evidenced by a sharp decline in TB notifications for both drug-sensitive and drug-resistant forms of TB," said VP Chiwenga.

"A high proportion (10 percent) of people notified in 2020 died. The majority of TB deaths occurred in Matabeleland South, Matabeleland North, Midlands and Bulawayo provinces which have between 11 percent and 18 percent death rates among TB patients."

The Zimbabwe TB epidemic is largely HIV-driven with a co-infection rate of 54 people in 2020. HIV testing in TB patients stood at 97 percent and ART coverage was 93 percent in 2020.

"This negative impact of Covid-19 is mainly related to stigma and reduced accessibility to health services leading to delays in TB diagnosis and treatment initiation. "Zimbabwe continues to suffer the scourge of drug-resistant TB which does not respond to the medicines normally used to treat TB," added VP Chiwenga.

In 2020, a total of 226 DR-TB cases were notified countrywide.

"The country is pursuing innovative community and facility-based systematic screening approaches for priority groups such as children, miners, contacts and diabetic patients. There has been a rapid scale-up of new diagnostic technologies such as the Xpert MTB/Rif Assay, Line Probe Assay and Digital Radiology, resulting in prompt diagnosis and treatment of TB and Drug Resistant TB. To date there are 140 GeneXpert machines in the country and 3 Line Probe Assay machines," he said.

"Decentralisation of DR-TB services has been done to district level to improve access to diagnosis and treatment at all levels. The country has introduced an injection-free DR-TB treatment as the preferred treatment for all patients with DRTB; recommended in the latest guidance from the World Health Organisation (WHO) on the management of DR-TB cases as part of improving the quality of care provided to these patients."

He also bemoaned the fact that 80 percent of TB-affected households suffer catastrophic costs due to TB.

"According to the national patient cost survey for TB patients and their households that was carried in 2018, the affected were forced to borrow money (39,3 percent), sell their assets (30,2 percent or do both (51,6 percent," added VP Chiwenga.

He said since TB and Covid-19 have a similarity there is a need to guard against the likelihood of missing TB in some patients who would be mimicking covid-19.

VP Chiwenga also said the removal of the lockdown and vaccination against covid-19 does not mean the pandemic is over. He emphasised the need for the population to protect against Covid-19 through proper wearing of masks, sanitisation of hands and all other preventive measures. I encourage all those who are eligible for vaccination to get vaccinated for the good of the nation in the pandemic.

"I would, therefore, like to acknowledge the development partners who have been supporting the National TB Control Programme over the years. These include the Global Fund, the WHO, the International Union Against Tuberculosis and Lung Disease, Medicines Sans Frontieres, Solidarmed, Elizabeth Glaser Pediatric Aids Foundation and the Clinton Health Access Initiative. Let me also recognize the appointment of TB Champions by the First Lady, Mrs Auxilia Mnangagwa through the National Stop TB Partnership Forum in May 2020. These are persons who include celebrities, radio and TV personalities, business persons, musicians and poets, sports persons, journalists and other important people as well as ex-TB patients," he added.

One of the TB champions Ms Soneni Gwizi, a media personality and disability activist, said TB remains a challenge even in children mostly due to the difficulty to diagnose the disease coupled with insufficient awareness of the magnitude of the problem of the disease.

"In most cases, parents justify signs and symptoms of TB in children such as weight loss, night sweats and cough preferring to use home remedies as a cure. Parents mostly focus on the baby's fontanel (inkanda) and by the time they take their child for TB treatment the disease might be difficult to manage," said Ms Gwizi.

"Losing a single person to a disease which is both preventable and curable is unethical. As others run for TB, due to my disability I walk for zero TB deaths in children," she added.

The ministry's TB Unit deputy director Dr Charles Sandy said an estimated 6 160 to 10 640 cases were missed in 2019 but this figure is likely higher in 2020.

"Proportion of TB in children remains low and has been hovering around 4 percent for a number of years. We are scaling up improvements in diagnostic tools and health workers' training to support TB detection in children better," said Dr Sandy.

"Part of our plans to address these challenges include increasing the treatment coverage of drug-susceptible TB from 83 percent in 2018 to 90 percent by 2025. We are also working on achieving universal HIV testing and ART coverage for TB cases by 2021 and sustain coverage through to 2025," he said.

Source - chronicle
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