Heath workers team up to fight TB

Every second someone in the world gets infected with the bacterium that causes tuberculosis. One third of the world’s population, around 2 billion people, already has this TB bacterium in their body.

It is for this reason that health workers in western Uganda goes knocking on doors of congested slums once a week to convince suspected tuberculosis (TB) patients to visit referral hospitals and submit a sample of their sputum.

The health workers have been doing this for the past three years in a bid to fight and prevent TB in the most congested slum areas of Kisenyi in Kabarole district, Biafra in Mbarara district and Nyendo Senyange in Masaka district. They set up tents as sputum collection centers to serve and counsel people from there.

They work with local leaders in the slums to mobilize and sensitize community members the dangers of TB and urge them to diagnose for the disease. They also use local radio stations to call people to come have them tested.

“We as health workers identified this cause and recognizes the effect of TB in congested slums and we want to save the people from getting this disease,” Dr Ronald Muhame, the in charge of Kibito health IV in Kabarole district said.

He said the group gets assistance from districts and local leaders. The samples are sent to the National TB and Leprosy Program (NTLP) whose overall functions are to establish country wide quality diagnosis and treatment services for TB and Leprosy and to coordinate the implementation of TB and Leprosy control activities. It also have specialized laboratories to test for TB.

TB remains a major public health problem in Uganda. According to the 2009 WHO Global TB Report, Uganda is ranked 16th among the 22 high burden countries. In addition, the country has an emerging multi drug resistant TB (MDRTB) problem.

Dr John Muhumuza who coordinates the group says that they also offer HIV/AIDS testing and counseling services to slum dwellers, saying that TB is common among people living with HIV and is the leading cause of death among HIV positive patients.

Dr Muhumuza expressed fear that despite their intervention, the level of infection has not gone down which he attributed to lack of treatment adherence of TB patients.

“Most people do not want to test while others refuse to adhere to the treatment which results into extremely drug-resistant (XXDR) TB,” he told Key Correspondent.

Dr Rhoda Tuhaise a TB expert said that four of the 12 patients detected with totally TDR, TB recently were from Biafra slum in Mbarara district.

She said that poor ventilation, lack of sunlight, dampness in the environment that favours the growth of TB bacteria in slum areas.

Stigma and challenge TB patients face

Those people who do develop tuberculosis face an exhausting disease. Treatment takes months and in many countries like Uganda people with TB face a huge social stigma. The disease often leads to loss of income and isolation.

Among them is Ronald Tukamubona, 35 who started TB treatment last month, used to visit private clinics but his problem was not solved.

A taxi driver Mbarara, Tukamubona lost his job because of absenteeism. He was off and on at his work place and he was weak most of the time until job that was demanding.

He has no idea that what he was suffering from was TB until he met a group of medical personal volunteers who were testing slum dwellers and grabbed the opportunity to test for the disease

“I lost my job after contracting TB and I was unable to perform my duties, I would cough all and day and night, not until I took sputum test and tested positive for TB. If I had known earlier I would have lost my job”, he said.

"The kind of discrimination I faced from my neighbours made me regret sharing my condition with them; I could not even share the communal toilet with them,”Kabakumba Annette a business woman in Fort Portal said.

Eight months into her marriage, Jolly Nampija was diagnosed with tuberculosis in January. She was hospitalized for a week at Masaka hospital but when she was discharged, her husband asked her to stay at her parents’ place in Kyotera in Rakai district saying he and his family had to travel to Kampala for a wedding and there was no one to take care of her.

For two weeks, her husband did not call to check on her. When her mother took her to her husband’s home, her mother-in-law said they didn’t want her in the house because she had TB.

“My husband wasn’t even ready to face me. My mattress, bed sheets and other belongings had been burned,” Nampija said.

Six months on Nampija has completed her course of TB treatment and was given the ‘all-clear’ by her doctor. “I don’t know if my husband and his family will ever take me back,” she said.

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Key international forum on plant viral diseases kicks off in Arusha, Tanzania

The 12th International Plant Virus Epidemiology (IPVE) symposium with the theme “Evolution, Ecology and Control of Plant Viruses,” started yesterday, bringing together over 200 scientists and leading experts on plant viruses from 40 countries all around the world.

 Dr Lava Kumar, a virologist with the International Institute of Tropical Agriculture (IITA) and chair of the 12th IPVE Symposium said in the next five days the delegates will share experiences and the latest knowledge and technologies to control plant viruses and mull over a global strategy to combat emerging and reemerging plant virus diseases.

They will especially focus on Africa. “The event is very special as it is taking place in Africa for the first time and will therefore devote a lot of time to explore the key challenges facing the continent in tackling the key viral diseases to increase agricultural productivity, food availability, and economic development,” said Kumar.

Dr Elly Kafiriti, the Director of the Naliendele Research Institute, while officially opening the event, noted the negative impact of plant viruses on food security in the continent where they were fueled by poor agronomic practices of resource-poor small-holder farmers.

 Dr Kafiriti, representing Dr Fidelis Myaka, the Director for Research and Development at the Ministry of Agriculture, Food Security and Cooperatives (MAFC), said the Tanzanian government is supportive of all efforts aimed at finding solutions to control plant viruses in the country to improve food security and especially research which provides knowledge and information to policymakers for informed decision making.

He pointed out the examples of the Cassava Brown Streak Disease and Cassava Mosaic Disease which were spreading to new areas in Eastern Africa, ravaging the crop and affecting food security. 

Dr Nteranya Sanginga, Director General, International Institute of Tropical Agriculture (IITA) of the CGIAR, also speaking at the forum, noted that Africa was changing for the better and so was its leadership. Its future is thus looking bright. However, he said there were a number of challenges that need to be addressed including viral diseases of staple crops such as cassava, banana, and maize using advances in science.

 He said cassava is going to be the crop of the future for Africa, noting that it is not just a food security crop but that it holds immense potential as an income earner as it is a source of industrial raw materials such as glucose and starch. “Cassava production is picking up in Nigeria, Malawi, Rwanda and Tanzania.  

Countries are changing from overreliance on maize. The future of this crop in the continent is bright. However, it faces many challenges including the two viral diseases that are a headache to our farmers and policymakers,” he said. “We need science to solve these problems.”Sanginga also emphasized the need to invest in building the capacity of young researchers for the future and said the symposium provided a great opportunity for young scientists and students to learn and interact with experienced researchers from all over the world. 

Other speakers included Dr Joseph Nduguru from the Mikocheni Agricultural Research Institute (MARI), also one of the conference organizers. He said that researchers of plant diseases still had a lot of challenges ahead of them as diseases were spreading.

 “We have more to do for the farmers I met at Mukono, Uganda, who lost their entire cassava crop due to CBSD and CMD. There is more to do for farmers of Kenya, Tanzania, and Uganda who are threatened by Maize Lethal Necrosis Disease,” he added.

Plant viruses are among the major factors that affect productivity and cause vast economic losses to staple crops in Africa and other developing regions across the tropics.

Furthermore, new viruses, new strains of existing viruses, along with changing contexts due to agricultural intensification and climate change are creating new challenges and demanding even greater effort to find novel, effective ways to tackle virus disease problems.

 The meeting is co-organized by IITA, MARI Tanzania, the National Agricultural Research Organization (NARO) of Uganda, AVRDC-The World Vegetable Center in Arusha, and CORAF under the auspices of the International Committee on Plant Virus Epidemiology (ICPVE). The IPVE is a specialist committee on plant virus epidemiology of the International Society of Plant Pathology (ISPP). The IPVE Committee has previously conducted 11 international symposia in different parts of the world.

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