‘Our priority is to findevery missing TB case’

Clad in a sky-blue uniform, Maison Kameta is a trusted community health worker at Chiringa Health Centre and in surrounding villages in Phalombe District. He goes village to village, working with local volunteers to identify suspected TB patients in the rural community. “When someone develops a cough that persists for at least two weeks, sudden weight loss or excessive night sweats, the volunteers discreetly approach them to discuss the importance of TB screening.

They take sputum for laboratory tests to ensure they know their status and start treatment immediately if found positive. We want to ensure no one dies of treatable conditions like TB,” Kameta says. The volunteers collect sputum from TB suspects in their neighbourhood and link the cases at risk of dying without knowing their status to healthcare workers for timely testing, treatment, care and support.

They also provide checks and balances, ensuring the results reach the source in time for treatment. Kameta narrates: “As community sputum collectors, we used to complain about delayed laboratory results. Our clients expect to get the results within three days, but some could wait for two months and some samples were expiring before being analysed.

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“We have dramatically cut the turnaround period with dialogue, collective lobbying for the necessary resources like a new Gene-Xpert machine and reagents. Clients now get their results the same day or within two days.” Team play between healthcare workers and the communities they serve has also boosted the detection of missing TB cases and treatment, leaving no one behind. “Together, we unearth hidden cases and issues that we rarely used to talk about.

Our community now has a say on efforts to make TB history,” says community consultative group data collector Hanna Katerera. The Ministry of Health and Sanitation reports that Malawi has registered tremendous declines in TB illnesses and deaths over the past decade. New data released by the National Tuberculosis and Leprosy Elimination Programme (NTLEP) highlights the tremendous decline attributed to sustained government leadership, improved case detection and strengthened community-based interventions.

The update shared during national dialogues on priorities for the Global Fund on TB, HIV and Malaria shows the country has almost halved TB incidence from 197 cases in 100 000 people in 2015 to 107 last year. The 46 percent drop in confirmed TB patients came alongside a 72 percent decade-long decline in deaths from 68 to 19 in a population of 100 000. This means Malawi is edging closer to achieving the global targets to end TB as a public health challenge by 2030. The lung disease is the largest killer of Malawians living with HIV.

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