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A recent visit to Thyolo District Hospital revealed that at least two out of every five patients receiving tuberculosis (TB) treatment had suffered from the disease previously.
Middle-aged Musta Madondolo (not his real name), a Blantyre businessman, was among the “relapse” cases at the hospital. When he was first diagnosed with the disease early last year little did he know he would be back on the long treatment a year later.
“I blame it on health workers at my home area health centre (name withheld) because they lost my drugs,” Madondolo said in an interview.
After two weeks of intensive medication at Thyolo District Hospital Madondolo got discharged to be taking the drugs at home under the direct observation of his wife and relatives. He was referred to Queen Elizabeth Central Hospital, from where he collected the drugs in bulk and surrendered them to the health centre for safekeeping. The health centre released the drugs to him in smaller tranches.
“All the drugs for my last month of treatment were reported missing when I visited the health centre. I did not complete the treatment because of that incident,” Madondolo said adding that he suspected the disease recurred because of his failure to complete treatment.
It was not possible to verify his claim with the health centre, but Thyolo district TB Officer Daniel Chilomo confirmed Madondolo was among the relapse cases.
“I suffered from the disease four years ago and never thought would have it again,” said 28 year-old Manesi Dayson (not her real name) from Thyolo.
She said she completed eight months of TB treatment four years ago and looked healthy until a few months ago when she suspected she had malaria or pneumonia. She visited Thyolo District Hospital and the examination revealed she had succumbed to TB again.
Like Madondolo and others at the hospital for similar predicaments, Dayson was admitted to the hospital to receive treatment, including Streptomycin injections, for three months. The district TB officer attributed the relapse cases to several factors.
“The major factor is low immunity,” Chilomo said adding that a person can suffer from TB for more than twice if the body does not have antibodies to fight against the bacteria that cause the disease.
Some cases can also relapse if the patient does not take the drugs according to the prescription or when a health worker administers wrong drugs on the patient.
Chilomo described the percentage of relapse cases in the district as small, pegging them at about four percent. However, he said his office is intensifying efforts to arrest incidences of TB, until now one of the major causes of death in the country.
Olesi Pasulani, Medicines Sans Frontiers (MSF) clinical coordinator at the hospital said that the HIV and Aids pandemic poses a big challenge to the fight against TB, the disease that usually attacks the lungs.
Because of HIV, the virus that causes Aids, the immunity of many people tends to be low rendering them vulnerable to diseases such as TB, he said adding that MSF is collaborating with Thyolo District Hospital to deal with HIV and Aids and TB simultaneously.
“Our plan is to provide free ARVs (ant-Aids drugs that prolong an HIV-infected person’s life) to every person with HIV who also suffers from TB,” Pasulani said.
Nearly 3,500 people receive free ARVs from the hospital and MSF intends to register 200 new clients every month. Some beneficiaries are said to be from places outside Thyolo district.
“The demand for ARVs is high and we are doing all we can to help the people,” Pasulani said adding that MSF is intensifying campaigns to encourage people to go for voluntary counselling and HIV testing (VCT) so that they can have access to the free drugs, if they are in need of the life-prolonging drugs.
Nearly one million people are living with HIV in the country and 170,000 of them require ARVs, according to official figures from the National Aids Commission (Nac).
The TB Control Programme, on the other hand, pegs the rate of TB patients who are also living with HIV at about 77 percent. Both HIV and Aids and TB are associated with poverty. Globally, the highest burden of the dual epidemic is found in poor countries such as Malawi.
Malawi has 246 TB patients in every 100,000 people and 800 patients have been dying every year.
Meanwhile, the TB Control Programme gathered its district officers and journalists for a two-week training programme in Lilongwe, as part of the government’s efforts to accelerate the fight against TB in the country.
“This course will equip the TB officers with all operations of TB at district level. It will also help journalists to understand better all issues surrounding TB,” said TB Control Programme communications officer Henry Chimbali at the start of the training programme.
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