Medical workers have rallied policymakers to support efforts aimed at increasing the detection and treatment of Tuberculosis (TB), saying there has been a setback in the fight against the disease following the outbreak of Covid-19. The call was made during a virtual meeting that brought together medical workers as Rwanda joined the world to mark the World Tuberculosis Day. World Tuberculosis Day is marked on March 24 every year. Like the rest of the world, Rwanda observed the day under the theme; “The clock is ticking” in order to convey the sense that the world is running out of time to act on the commitments of global leader to end TB by 2035. In Rwanda, there was a substantial decrease (7 per cent) in TB case notification during the first six months of 2020, compared to the same period in the previous year, a worrying decrease that could lead to a spike in TB related deaths. This is according to Dr. Patrick Migambi, Division Manager of Tuberculosis and other respiratory diseases at Rwanda Biomedical Centre (RBC). In contrast, however, Migambi noted that there was no corresponding decline in treatment despite various travel restrictions, thanks to the support from Community Health Workers. Migambi noted that among the 5,678 TB cases recorded in 2019, some 930 (16.4 per cent) of them were brought by Community Health Workers. He added that TB among children under 15 years remains at 6 per cent while cases among the high-risk groups are at 50.4 per cent. The high-risk groups include people living with HIV/AIDS, prisoners, TB contacts, children under 15 years and people aged 55 years and above. “Tuberculosis is among the top ten killer diseases globally. In 2019 alone, the world lost 1.2 million people. That is almost 3000 people per day, we should be increasing TB services not decreasing them.” he said. “There has never been a more critical time to ensure continuity of essential services for people affected by TB. If people are unable to receive uninterrupted treatment, we risk losing more lives.” Globally, a new research by the Stop TB Partnership shows that during the pandemic, the number of people detected, diagnosed with and treated for TB dropped by approximately one million, falling back to 2008 levels. Progress made On a positive note, the Director General of Clinical Services at the Ministry of Health Dr Corneille Ntihaba said that the fight towards TB end in Rwanda has made progress as well impressive achievements despite battling the pandemic. “Efforts were made to reach patients with accurate TB diagnosis and effective treatment,” he said. Community Health Workers in their capacity helped to deliver drugs to patients, ensure compliance with the treatment, and provide psychosocial support, he reiterated. Ntihaba decried that there is still a low treatment success rate (86.4%), attributing the development to delayed diagnosis. “86.4 per cent is not a bad percentage at all, but we are aiming at 90 per cent. The remaining 14 per cent is quite a big number and this can be achieved if all sectors come together.” In addition, he said that the country had seen a 40 per cent drop in incident cases in the past twenty years. Plan to treat all patients living with HIV/ AIDS. According to Ntihaba, the government has rolled out an initiative to implement Tuberculosis Preventive Therapy (TPT) among people living with HIV, as part of the efforts to reduce cases especially in high-risk groups. HIV/AIDS accounts for most cases among high-risk groups. “We have so far rolled out the plan to five district hospitals and scale-up will be done this year.” Besides people living with the virus, Dr Ntihaba said that the initiative aims at testing and tracing children under five years and above 12 months as well as household contacts for the patients. “As the theme suggests, working around the clock means we are only left with 14 years. This is rather a short time and requires us to double our efforts,” he said. The World Health Global TB Report 2020, indicates that an estimated 10.0 million people fell ill with TB in 2019, a number that has been declining in recent years. According to the report, there were an estimated 1.2 million TB deaths among HIV-negative people in 2019. And 8.2 per cent of the total cases were people living with HIV. In his remarks, the Minister of Health, Dr. Daniel Ngamije noted that the government will put more emphasis on treating and tracing patients. Ngamije also said that there is need to invest in more campaigns in order to ensure capacity building at the same time waiving any form of charges from patients. This, he said, will be the country’s contribution towards the global initiative to end tuberculosis by 2035.
