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Experts report drop in detection of drug resistant TB

Kampala, Uganda | THE INDEPENDENT | Experts have called for a new survey to determine the current prevalence of Multi-Drug Resistant Tuberculosis with information got at hospital level showing low detection of the disease and enrollment into care.

Dr Susan Adakun, the head of the TB unit in Mulago National Referral Hospital notes that the detection capacity of the disease currently stands at 40 percent and predicts that it may fall to the lows of 20 percent with the disruptions caused by the coronavirus pandemic.

Even as the World Health Organization released new guidelines early this year and countries including Uganda adopted new drugs which take a shorter duration, Adakun says some patients have already started resisting them. At Mulago alone, five patients have so far resisted the new drugs.

Since January to date, a total of 168 patients at Mulago have been enrolled on the new modified oral treatment and a review on treatment outcomes is set to be conducted next month.

While several people are enrolled in care, the doctor notes that the TB programme faces a major hurdle in surveillance and tracing contacts and yet the data used to inform decisions regarding MDR-TB interventions are based on a 2010 survey which doesn’t represent what is presently on the ground.

80,000 Ugandans are estimated to be infected with TB whereby according to the prevalence survey, one in every 100 newly diagnosed cases and 12 in every 100 previously treated cases are battling MDR TB in Uganda.

With such a picture, several interventions have been adopted by the government to ensure that people adhere to treatment including shifting patients to shorter regimen duration from up to 20 months to six months on treatment and creating an enabler programme where patients are given monetary facilitation for things like transport refunds such that people can ably access care.

As a result of such interventions, Dr Stavia Turyahabwe, the Assistant Commissioner Health services in charge of TB control in the Ministry of Health says mortality has reduced.

She however acknowledges that they are currently challenged with diagnosing new patients considering the similarities between the disease and COVID-19.

She said surveillance teams are reporting that health workers are hesitant to look at sputum for fear of getting infected which has as a result affected case finding and later on interventions into care such as finding contacts of the infected people.

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