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Rumbidzayi Zinyuke recently in Kwekwe
Zimbabwe has made significant strides towards once again pushing back tuberculosis through targeted identification, prevention and control programmes that have resulted in a decline in new cases in the past few years.
The incidence of TB has declined from more than 36 000 new cases in 2015 to about 29 000 new cases last year owing to an increase in TB services across the country.
Last year, the World Health Organisation removed Zimbabwe from the list of 30 countries with a high TB burden but Zimbabwe remains in the top 30 countries with a high burden of TB driven by HIV and multi-drug resistant-TB.
Speaking at a media orientation on TB control in Kwekwe last week, Dr Mxolisi Ngwenya from the Ministry of Health and Child Care said the National TB programme had recorded major improvements owing to the programmes being implemented.
“As a programme, we have had a decline in new cases of TB and this is because of the extensive work that we have been doing to look for TB cases.
In terms of indicators linking TB with HIV indicators, he said: “Wwe know that TB and HIV are closely related so we have adopted the integrated TB and HIV care system. You will notice that when you get to a clinic, where they are doing TB screening, that is where they do HIV as well because the moment we suspect that you have TB, we test you for HIV and we know how to manage you. This has been so successful in that we know the HIV status of 99,9 percent of people with TB,” he said.
Dr Ngwenya said in terms of diagnostic services, the programme had an integrated system which had reduced the turnaround time for results on TB samples to less than six days.
The national tuberculosis programme has also been supported by the United States Agency for International Development through the Kunda-Nqob’iTB (KN-TB) project, which is being implemented in eight districts with a high disease burden.
The programme is being implemented through a consortium of four partners that include the Union Zimbabwe Trust, Jointed Hands Welfare Organization, Hospice Palliative Care Association of Zimbabwe and Baines Occupational Health Services
Since its inception in 2019, the programme has identified a total of 7 317 new TB cases in the target areas, representing 16 percent of the total TB cases reported in the country.
Union Zimbabwe Trust technical director Dr Sithabiso Dube said through the programme, village health workers had contributed a lot in the diagnosis of TB within the communities.
The districts covered are: Gweru, Gwanda, Zvishavane,Inziza, Shurugwi, Chirumanzu, Kwekwe and Mwenezi.
“These districts were selected because they have poor outcomes for TB, high numbers of TB notifications and also high concentration of artisanal small scale miners. This special group is particularly susceptible to TB because of the conditions in which they work. Sometimes they don’t have protective gear and they can get exposed to silica dust, which makes them susceptible to getting TB,” she said.
She said since inception of the programme, 5 635 artisanal and small scale miners had been screened with 364 diagnosed of TB while 901 were diagnosed with silicosis and 543 with HIV since project inception.
“The same group also has high prevalence of HIV and because of this, we focus on outreaches and occupational health clinics to make sure we are screening for TB. This has really seen a high yield as compared to the normal population.
“Artisanal small scale miners are a group with high yield of TB, HIV and silicosis. We are trying strategies to increase active case finding in the community during outreaches as well as having specialised clinics within provincial hospitals, one in Gwanda and another in Gweru,” she said.
Dr Dube said there were plans to continue scaling up the programme to regain some of the setbacks experienced during the Covid-19 pandemic when more TB patients were missed.
She said the correlation between Covid-19 and TB needed continuous research to improve outcomes in the event of a coinfection.
“We are looking at expanding the KN-TB programme to cover the four more districts of Sanyati, Chegutu, Shamva and Mazowe which have a similar profile. This will increase the population reach from 1,6 million to about 2,6 million people and contribute to finding an additional 4,534 TB cases over two years,” added Dr Dube.
Online Reporter