By Rachel Kakraba
Senior Technical Officer Global Fund Community System Strengthening Programme, at the Christian Health Association of Ghana, CHAG, Dr. Francis Adjei Osei, says expanding Tuberculosis, TB screening beyond hospitals to communities, to include churches, mosques and prayer camps among others is key to containing the disease. He said it is a move that will not only get more people screened for TB but also ensure people who test positive are promptly linked to care. Dr. Osei, in an exclusive interview with GBCNEWS, disclosed that already a similar intervention by the Association, where TB screening has been expanded to pharmacies is yielding positive results.
“In Ghana, the question is where do people go when they are sick? If everybody is to go to the health center when they are sick then the diagnosis will be easier. But we know that people go to the extent of seeing herbalists when they are sick, and the herbalist will try to treat you whichever means with the herbs, but it may not work if truly it is TB. Advance screening services to pharmacy shops.”
About tuberculosis
Tuberculosis (TB) is an infectious disease that most often affects the lungs and is caused by a type of bacteria. Symptoms include coughing, weight loss, sweating at night even when it’s cold, fever and loss of appetite. The World Health Organization estimates that about a quarter of the global population has been infected with TB, of the total number, about 90% are adults, with more cases among men than women. A total of 16,650 cases of tuberculosis (TB) were detected in Ghana last year, which is an increase of 20 per cent, of the 13,278 cases detected in 2021. Until the coronavirus (COVID-19) pandemic, TB was the leading cause of death from a single infectious agent, ranking above HIV/AIDS. Fighting TB is one that the Programme Manager of the National Tuberculosis Programme, Dr Yaw Adusi-Poku, has said calls for collaboration of other stakeholders, especially Non-governmental Organizations.
Christian Health Association of Ghana
One such institution which has been instrumental in ending this preventable and curable disease, is the Christian Health Association of Ghana, CHAG. CHAG is a network of Christian denominations that provides healthcare services. With more than three hundred health facilities, it provides services to the most vulnerable and underprivileged population groups in all 16 Regions of Ghana, particularly in the most remote areas. It has been embarking on a number of initiatives to reduce TB incidence by 25% from 148 in 2018 to 111 per 100,000 population by 2025.
Senior Technical Officer Global Fund Community System Strengthening Programme, at the Christian Health Association of Ghana, CHAG, Dr. Francis Adjei Osei, is concerned that some persons living with the disease are left undiagnosed. It becomes even more worrying as the 2022 global TB report indicates that Growth in the number of people with undiagnosed and untreated TB will result in an increase in the number of deaths from TB within a relatively short time frame. In Ghana, it is estimated that out of the 45, 000 new TB cases, 13,600 representing 30 per cent are timely diagnosed and put on treatment. This means 70 per cent of Ghanaians affected by TB are not detected and put on life-saving medication. As a stop-gap measure, Dr. Osei says CHAG has scaled up TB screening to pharmacies. This is because it is usually the first port of call for many sick persons in Ghana, including persons with TB symptoms.
“We still have over thirty-three thousand people that are walking undiagnosed of tuberculosis, with the effort by the Christian Health Association of Ghana coupled with the Ghana Health Service and other Non governmental organisations, am certained that we will have a different story to tell come 2030 when we assess the overall performance of the country in terms of combating TB”
As to how Ghana has been fared generally in tackling TB, Dr. Osei said all hope is not lost. However, stigma still remains a challenge. He was quick to add that the local name of TB as “nsaman wa” which literally means cough of death, is one that heightens stigma associated with the disease.
He said CHAG is leading efforts at reviewing all laws on TB to make it more punitive against people who stigmatize. He said it is also engaging services of community paralegals some of whom are cured TB patients and persons living with HIV who are attached to health facilities to provide psychological support to patients.
“At our level what we are doing now is working with community Peer Paralegals ( community peer paralegals are those that have been cured of TB) and we have some persons living with HIV who are also helping. The peer paralegals are assigned to some health facilities and they are given education on TB and also telling people about their rights and what to do when people stigmatize against them”
Adding on, Dr. Osei said, “we are working with another group called the pro bono lawyers. They are people who come after you when you stigmatize against people living with TB”
In one of the country’s leading regional hospitals is a block where TB patients are treated. This is a situation which puts fear in visiting family and friends. Seeking his view on this he noted such practice contributes to stigma within health facilities.
“You must see every person that comes to the hospital as potentially having some infectious diseases. When treating a patient make sure you are wearing a mask, gloves and also change gloves when attending to multiple patients. Key precautions must be applied to everybody. The moment you begin to be conscious because you have seen a TB patient you are not being professional in your duties as a healthcare professional.”
The Director-General of the World Health Organization Dr Tedros Ghebreyesus, once said “If the covid 19 pandemic taught the world anything, it’s that with solidarity, determination, innovation and the equitable use of tools, severe health threats can be overcome, urging that such lessons are applied to end tuberculosis. It may therefore not be out of place to part some institutions such as CHAG, for being unrelentless. After all, if such solidarity is what it takes to end TB then Ghana is certainly on the right path.