admin
Catherine Murombedzi HIV Issues
IN Zimbabwe, lung diseases are treated with concern and there are follow-up mechanisms from the health care provider if one is diagnosed with tuberculosis (TB). TB management is at public health care institutions and even patients from the private doctors and private health care facilities are referred to Government hospitals for proper care.
TB treatment is offered free of charge and the main drugs rifampicin and isonizad together with a host of other drugs are in use. However, there are cases when these fail and there is need to use more efficacious drugs. In Zimbabwe, the majority of hospital admissions are due to lung diseases. A greater number which is 60 percent have a compromised immunity together with TB.
The combination of TB and HIV has put a strain on the health care system and has seen the follow-up treatment which in the 90s was possible now being a thing of the past.
In the 90s, anyone suffering from tuberculosis had home visits from the nearest health facility and was monitored in taking daily doses. This is no longer possible given the economic challenges the country is facing.
In the 90s, World Health Organisation (WHO) declared TB an emergency and Zimbabwe treated it so.
With the HIV co-infection that most patients report with at health institutions locally, the strain has been felt as the country has had a brain drain with qualified health personnel, nurses, doctors, laboratory technicians and pharmacists seeking greener pastures abroad leaving newly qualified staff to fill in the gap.
The National Aids Council was founded in 1999 and by 2000 the organisation was working at national level.
President Mugabe also declared HIV a national emergency and it still is. There has been an improved service delivery, but the country is far from being comfortable.
When one is diagnosed with TB, daily treatment is started. Monitoring of the client is also done as they keep track of the patient. If one is also HIV positive then counseling is commenced before putting one on anti retroviral therapy (ART).
Art retention and quality care is offered but at times the specialised service that is needed is found lacking.
Dr Owen Mugurungi, the national director in the Aids and TB unit in the Ministry of Health and Child Care speaking to journalists in Kadoma last year said the country took TB treatment seriously and therefore any loopholes were tightened as these would prove costly if not well handled.
“The diagnosis, treatment, care and follow-up procedure is of great concern to the health ministry. Any leakages will be costly, so we treat TB with the care it deserves. In the 90s we had health assistants making follow-ups in homes and captured nearly all the diagnosed cases,” said Dr Mugurungi.
In Zimbabwe, 95 percent to 97 percent of TB patients know their HIV status. Data collected by the National Aids Council in 2014 showed that 69 percent of TB patients were HIV positive.
The country’s ART coverage has improved over the years as seen by more people being registered. This is an important aspect as there is a co-relation between TB and HIV.
“In 2010, ART coverage was at 44 percent and a year later rose to 60 percent. In 2012, it further improved and 70 percent patients got anti retroviral therapy. In 2013, the country got to universal coverage and had 80 percent patients in need of ART now covered,” Dr Mugurungi said.
There is still a challenge in children as TB diagnosis for children is still difficult. This has led to poor attention and with fatalities at times.
“National pediatric ART is at 46 percent and the country needs to scale this up if we are to get children on an equal footing with adults,” said Dr Mugurungi.
“In the coming years we intend to get pediatric ART get over 70 percent,” he said.
“HIV positive patients with chronic cough are offered TB screening. All TB and HIV co-infected patients get cotrimoxazole and ARVs.
We are training health personnel in TB/HIV management. We also are strengthening the daily observed treatment scheme,” said Dr Mugurungi.
Stigma still impacts negatively on TB screening as patients usually report late and are then found to be co-infected.
The future lies in children and this generation needs to get full medical attention if the spread of lung diseases is to be combated beyond 2020.
Feedback:[email protected]
Online Reporter