While it is a challenge to have a clinical diagnosis for children with tuberculosis, the Ministry of Health seeks to improve capacity building for health workers for early diagnosis and treatment so as to end the disease among children. The efforts to end tuberculosis (TB) among other high-risk people as well were disclosed as Rwanda marked World Tuberculosis Day on Thursday, March 24. Around 6.8 per cent of tuberculosis patients are children aged 15 and below. Health officials say that it is hard to diagnose TB among them based on sputum (to test the presence of bacillus mycobacterium tuberculosis), they rather observe common symptoms exhibited and treat them. Sputum is a mixture of saliva and mucus coughed up from the respiratory tract, typically as a result of infection or other disease and often examined microscopically to aid medical diagnosis. This year’s theme dubbed “Invest to end TB. Save lives” emphasizes the urgent need to invest the resources necessary to ramp up the fight against Tuberculosis (TB) and realize the commitments to end TB made by global leaders. Current situation Globally, data from the World Health Organisation indicate that 9,900,000 people fell ill with TB in 2020 and 1,500,000 died of it. In Rwanda, Dr. Patrick Migambi, Coordinator of National Tuberculosis and Leprosy Program, said that during the fiscal year 2020/21, the total TB cases diagnosed were 5,835, of which 85 per cent were ill of Pulmonary Tuberculosis, which is the most infectious. Pulmonary TB is a bacterial infection of the lungs that can cause a range of symptoms, including chest pain, breathlessness, and severe coughing. Of the total TB cases diagnosed, 28 cases were multi-drug-resistant tuberculosis (MDR-TB) cases, where the patient should be treated in a period of nine months to two years, he said. Persons at high risk of this infectious disease include people with HIV/AIDS, children aged 15 and below, people who live with TB patients, inmates, workers in mines, and people who have diabetes. Migambi said that 88 per cent of infected people get fully cured after they have taken medicine properly, while eight per cent of them die even while they are taking medicines. However, the death rate is higher at 17 per cent among people with HIV. On the other hand, he said that surveys have shown that only 40 per cent of symptomatic people go to hospitals to seek treatment, which reflects the gap of awareness and mindset change. With one per cent of diagnosed patients who escape the treatment program and develop the MDR-TB, he said that they are the major cause of continued spread of TB among the community. Intervention Migambi emphasized that people should be aware that tuberculosis is curable and it takes around six months of treatment to be cured with exception of MDR-TB which might extend to two years relatively. “Anyone with a cough that lasts for more than two weeks should seek out diagnosis at any health facility for proper treatment and follow up, free of charge,” he said. He disclosed that the overall budget spent on TB treatment is $8,360,000 and 40 per cent is covered by the government while the rest is provided by different partners. Dr Vianney Byiringiro Rusisiro, the director of TB Infection Control Unit at Rwanda Biomedical Centre (RBC), said that interventions to end TB include; capacity building among health care providers and community health workers, which is done through training on the modern ways of diagnosing TB. He also said that there needs continuous awareness among the people to encourage early diagnosis and treatment as well as breaking some myths that TB symptoms are results of witchcraft.
