Saving Lives Door to Door

Finding the missing TB cases in the Democratic Republic of the Congo
by Jean-Pierre Simelo & Tristan Bayly

Tuberculosis is a leading cause of death in the Democratic Republic of the Congo (DRC), as the number of people with the disease being located is far too low, and there is little knowledge or awareness of the disease’s symptoms. Many people still rely on traditional healers when they get sick, and are not referred to health centers when their health does not improve.

Around 120,000 TB cases were reported to health authorities in 2015, but there are an estimated 250,000 cases in the country. Finding these missing TB cases is critical in bringing a stop to the TB epidemic in DRC, and saving countless lives.

The story of Mwika Suzanne, age 37 and mother of three, is like so many others in DRC. For a long time she lived in despair with undiagnosed TB, she continued getting sicker and in the end her family were sure that she would die.

The USAID-funded Challenge TB project launched a campaign in various health zones to improve the quality of and access to care for TB and TB/HIV patients. Part of the campaign was to strengthen outreach by going door-to-door, treating patients and looking for anyone with TB symptoms.
Challenge TB’s partner on the ground the National League Against Tuberculosis and Leprosy (LNAC) visited one of Suzanne’s neighbors who was being treated for TB, and while they were there Suzanne’s sister asked that they come and visit her.

Martin, the coordinator of the LNAC in Lubumbashi said:

“We met Suzanne after we visited another patient. We immediately collected a sputum sample from her which was tested at the hospital, but the results were negative for TB.”
Suzanne when she began treatment — her low weight is clear

“Given how sick Suzanne was, we decided to take her to the hospital for further testing. After a clinical examination and further testing, she was finally diagnosed with both TB and HIV and remained at the hospital to undergo treatment. Amazingly after only a few weeks she had already regained enough strength to return home and continue treatment as an outpatient.”

“I am much better now and I am working again”, says Suzanne, “I am so grateful, because it is through this campaign that I was found and treated. My family had previously kept me at home and a traditional healer had treated me, but without any success. Now I am getting the right treatment and I feel so much better.”

During the campaign, 18 people including members of LNAC and volunteers who often provide health support on community activities, were trained on the symptoms of TB and on how to collect sputum samples for testing. They then visited 3,838 homes, screening a total of 15,299 people. Of those screened, 1,387 people with TB symptoms were tested, and a total of 46 TB cases were ultimately diagnosed, each of which had the potential to infect many more people if they hadn’t been found and treated.

Suzanne (l) looks so much better after just three months of treatment

Suzanne is just one example of the community outreach program’s success. In light of this, that LNAC will continue to work to improve the management, detection and treatment of TB and TB/HIV through the involvement of communities.

Dr. Hugues Kakompe, Chief Medical Officer of Kampemba, welcomed the campaign saying:

“It has boosted TB/HIV detection in our area and we believe this is an effective strategy. It will be sustained as there are still many many more TB cases to be found.”

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