The World Tuberculosis Day held on March 24th each year, is designated to build general public awareness that tuberculosis remains an epidemic in much of the world, causing deaths of nearly 1.5 million people each year, mostly in developing countries. It commemorates the day in 1882 when Dr Robert Koch astounded the scientific community by announcing that he had discovered the cause of tuberculosis, the TB bacillus.

At the time of Dr Koch’s announcement in Berlin, TB was raging through Europe and the Americas, causing the death of one out of every seven people. Dr Koch’s discovery opened the way for diagnosing and curing TB. World Tuberculosis Day can be traced back to 1982, when the International Union against Tuberculosis and Lung Disease launched the World TB Day on March 24 that year, to coincide with the 100th anniversary of Dr Koch’s discovery.

Tuberculosis is an infectious bacterial disease caused by mycobacterium tuberculosis, which most commonly affects the lungs but may affect other parts of the body. It is transmitted from person to person via droplets from the throat and lungs of people with the disease.

Tuberculosis was one of the top 10 causes of death worldwide. In 2015 according to the World Health Organization in their Global TB report, TB was responsible for more deaths than HIV and Malaria. In the same year, there were an estimated 10.4 million new TB cases worldwide of which 5.9 million were men, 3.5 million were women and 1 million were children. People living with HIV accounted for 11% of the total. Sixty percent of total new TB cases are from six countries, India, Indonesia, China, Nigeria, Pakistan and South Africa. One million and eight hundred thousand people died from TB that includes people living with HIV. Of these, men, women and children represented 61%, 28% and 11% respectively.

TB control in Rwanda has made good progress and impressive achievements due to strong political commitment by the Government of Rwanda and the participation of the community. Efforts have been made to reach TB patients with early and accurate TB diagnosis and effective treatment. Considerable efforts and resources are dedicated to finding TB cases among the general population with participation of Community Health Workers and NGOs.

The global target is to end TB by 2035 as one of the 3.3 of SDGs indicator, Rwanda will continue to work and ensure that these targets are achieved.

According to the WHO Global TB report 2016 the TB incidence rate for Rwanda is at 56/100.000 people and TB mortality rate is 3.8/100.000. The results of Drug Resistant survey (DRS) conducted in 2005 revealed that 3.9% new TB cases and 9.6% of previously TB cases developed Multi Drug Resistant TB while the recent result Drug Resistant survey conducted in 2015 revealed that 1.4% of new cases and 10.7% for previously TB treated developed Multi Drug Resistant TB which is significant decrease among the new TB cases. The combined TB MDR prevalence decreased from 4.6% to 2.1%.

ACHIEVEMENTS

Every year Community Health Workers contribute to 46% of TB presumptives referred to health facilities and 25% of TB cases that are eventually diagnosed;

Screening of TB was reinforced among High Risk Groups especially contacts of TB cases, people infected with HIV and prisoners;

The trend of TB cases decline since June 2011 from 7230 to 5763 TB cases all form in June 2016 while increasing efforts for TB detection;

Genexpert machines were purchased and installed in all district hospitals to improve the detection of TB and early identification of MDR TB cases;

Currently 94% of all co-infected TB/HIV received ART before the end of TB treatment;

The Treatment success rate for bacteriologically confirmed new and relapse TB cases was 90% of the cohort of TB cases registered in the 2014-2015 financial year. This decrease transmissions of TB to healthy people;

95% of TB cases followed by CHW were successfully treated;

85 % of MDR-TB cases of the July 2013 to June 2014 for the long (20 months) treatment regimen and July 2014 to June 2015 for the shorter (9 months) regimen cohorts were successfully treated

Rwanda introduced the individual Electronic TB record system during the 2015-2016 FY.

CHALLENGES

Notification of TB remains under expectations in general population despite some active cases finding activities and good TB laboratory QA (quality assurance) interventions. However, we cannot reach the undiagnosed TB cases without availing sensitive diagnostic tools at the patient entry point.

The rate of detection of TB among children under 15 years still remains a challenge.

Maintaining the reduction of TB burden in Rwanda will remain a challenge if efforts to control TB regionally aren’t strengthened since Rwanda neighbours four of the 22 high TB burden countries in the world (Kenya, Tanzania, Uganda and DRC).

GOALS AND OBJECTIVES OF THE EVENT

As Rwanda joins the rest of the world to mark the World TB Day 2017, RBC will use this opportunity to raise awareness of the local authorities, health care providers, community health workers and the general public to the fight against Tuberculosis. For 2017, we will focus on youth in Kigali because Kigali City produces around 30% of total TB cases notified country wide.

The main objective of marking this day in Rwanda is to increase awareness among the public that TB is preventable and curable and will also teach about TB diagnosis, treatment and prevention in order to ensure access to adequate TB care,

The theme of this year’s World TB Day is: "Unite to End TB”

ACTIVITIES

As we target the youth, we will work closely with National Youth Council (NYC) which has strong experience in working with the youth. Activities will involve youth from Nyarugenge, Gasabo and Kicukiro Districts to generate an effective movement in fighting TB. Highly motivated youth ambassadors have already participated in further sensitization of youth in the city of Kigali.

In the process, a creative network of youth ambassadors will be set up to mobilize and sensitize peers and families but also the community at large on how to control and prevent tuberculosis.

Many activities will be planned in other provinces that include advocacy, communication and social mobilization.