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Tuberculosis Community Outreaches – finding undetected community TB cases

By: Dr. George Alwodo – HIV/TB Specialist & Edward Bulolo Bossa - Counsellor AIC

Magala Azzizi (23) lives in Mwiri village, Kakira Sub County in Jinja district with his elderly grandmother. In mid-2020, Azzizi was returned from Iganga and dumped at his grandmother’s home in a critical medical condition. He had been living and working in Iganga as a builder before becoming severely sick. Azzizi was terrified by the thought of testing for HIV having known that his partner had already tested positive. “While in Iganga, I learnt that my partner was HIV positive and I was not ready to go through the process of knowing my status. I was sure that I was also infected”, narrates Azzizi.

 

It was during a village door to door visit that the village health team member (VHT) of Mwiri got to know of Azzizi’s condition. By the time I found him, he was looking pale, anemic was suffering from severe acute malnutrition. He had been bedridden for over a year. His living conditions were deplorable. The relatives he was living with had isolated him in a small room and could only see him when dropping for him food.

 

In June 2021, the AIDS Information Centre (AIC) Jinja branch conducted a community Tuberculosis (TB) hot spot screening in Kakira Sub County. Working alongside the VHTs, Azzizi was visited at home and counselled to test for HIV and screened for TB. “He had all the signs and symptoms of TB. The process went on smoothly, his HIV sero status was Negative, but the sputum sample turned positive using the GeneXpert. When informed of his HIV negative status, Azzizi could not hide his joy since he was very worried that he was HIV positive”, narrates Edward, a Counselor from AIC.

Photo 1: Client (in red T-shirt) being supported by a Health Worker from AIC Jinja to start TB initial phase
Photo 1: Client (in red T-shirt) being supported by a Health Worker from AIC Jinja to start TB initial phase
Photo 2: Client (in white long-sleeved shirt) being supported to start TB continuation phase by a health worker from AIC Jinja
Photo 2: Client (in white long-sleeved shirt) being supported to start TB continuation phase by a health worker from AIC Jinja

Azzizi received TB health education and was sensitized on the side effects of the TB drugs. He was enrolled onto TB treatment lasting six months. Six of the family members within Azzizi’s homestead were screened for TB and enrolled onto Tuberculosis preventive treatment (TPT). The family members were sensitized on treatment support and showing love and encouragement to the patient to improve treatment outcomes.

 

“We realized that most of the males 30+ years preferred to come to the facility beyond 5 o’clock given their working schedules and also not wanting to be mixed with the other age categories consequently we had to adjust the working hours to accommodate this category and avail them the services”, says the VMMC Focal Person at the facility.

 

In December 2021, Azzizi was retested and confirmed TB negative upon completion of six months on anti TB medication. He has resumed his work as a builder and integrating back into the community. This is one of the many cases of unknowing TB patients that are in the community and have poor health seeking behaviours. Many stand the risk of dying undiagnosed since they do not visit health facilities. USAID LSDA, through its supported health facilities embarked on Community TB hotspot mapping and conducting outreach clinics in these hotpots. This approach has proved helpful in discovering undetected TB cases and treating them.