Tuberculosis: Our Impact

{Photo Credit: Michael Paydos/MSH}Photo Credit: Michael Paydos/MSH

Tuberculosis is one of the top causes of death globally. In many of the countries most affected by this disease, drug sellers—also known as private pharmacies—are the first point of contact for people seeking health care. By some estimates, about 50 percent of TB patients’ first contact with the health system is from a private pharmacy.

{Photo Credit: Diana Tumuhairwe/MSH}Photo Credit: Diana Tumuhairwe/MSH

At six months pregnant, Angela Namatovu was excited. The pregnancy was going well, and she could not wait to give birth to her baby boy. Like any careful expectant mother, when she developed a cough, she knew that the right thing to do was seek medical attention. She went to a nearby local clinic in the Simbwe, Wakiso district in central Uganda, not thinking her symptom was anything serious. The health facility could not find anything wrong but still referred her to Mulago Hospital. There, she was asked for sputum samples and was also given medication for 10 days.

 {Photo Credit: Males Emmanuel/MSH}Baby Mary after two successful weeks on anti-TB treatmentPhoto Credit: Males Emmanuel/MSH

At nine months old, Mary Yeno had lived with TB for nearly half of her short life before being accurately diagnosed and treated. Mary’s mother, Flora Faida, carried the baby to three different health facilities without success. “She was coughing and had difficulty breathing. She stopped breastfeeding,” Faida said.

 {Photo Credit: Landry Serges-Malaba/MSH}Alain Kelende, mason and former TB patientPhoto Credit: Landry Serges-Malaba/MSH

Alain Kelende had been a mason his whole life, but for the past two years, he was exhausted every day and could not stop coughing, making it difficult to work. Kelende, 42, lives with his wife and two children in a peri-urban community of Kinshasa. Like many in Democratic Republic of the Congo (DRC), he resisted going to a clinic. Instead, he self-medicated for worms and, he said, “kept coughing and growing weaker.”

The Systems for Improved Access to Pharmaceuticals and Services (SIAPS) project, funded by USAID and led by MSH, has conducted a global survey about e-TB Manager, an electronic management tool for tuberculosis (TB) control programs. More than 1700 users from around the world participated in the survey, which asked respondents about their experiences and satisfaction using the tool.

 {Photo credit: MSH staff}Kasifa Mugala, 34, started feeling ill while she was pregnant, and started ART after referral for prevention of mother-to-child transmission of HIV. “I am very happy. I gave birth to a healthy baby who is now turning one year old,” she said. “I did not know that I would ever be fine. I am grateful to our village health team.”Photo credit: MSH staff

Esther Nyende, 45, is a member of her village health team and a community leader in Uganda’s eastern Pallisa District. Nyende alone has referred 20 clients who are now receiving antiretroviral therapy (ART).

{Photo Credit: MSH Staff}Photo Credit: MSH Staff

Management Sciences for Health has been working closely in collaboration with the Global Alliance for TB Drug Development (TB Alliance) on the introduction of the new dispersible pediatric fixed-dose combination. Through MSH’s projects across identified high-burden countries, we have been providing assistance on updating treatment guidelines and essential medicines lists, registration of the reformulated product, financing and reprogramming grants, quantification, and training healthcare providers on the medicine and its use. 

 {Photo: HEAL TB Ethiopia}Aster Gemede and her daughter, Lemlem, at a TB clinic in Borena.Photo: HEAL TB Ethiopia

Aster Gemede lost her husband to tuberculosis (TB) meningitis early in 2012. Struck with grief, Gemede did not notice her own deteriorating health in the months after his death. Cough, fever, chest pain, and loss of appetite became part of her everyday life. She hardly noticed she was losing weight. When Gemede got to the point where she was unable to look after her two children, she was forced to walk eight hours from her home in rural Borena zone, Oromia, Ethiopia, to the nearest health facility.  

 {Photo credit: Francis Hajong/MSH}Anika and her mother.Photo credit: Francis Hajong/MSH

Anika was a 22-month-old baby girl living in Belai Chandi Kuthipara in the northern part of Bangladesh when she became sick with fever, cough, and weight loss. She was admitted to the LAMB’s Missionary Hospital in Parbotipur, run by one of the many NGOs where the US Agency for International Development (USAID)-funded Challenge TB project, led by Management Sciences for health (MSH) in Bangladesh, is funding active tuberculosis (TB) case finding among high-risk groups such as children, people living with HIV, and diabetics.

 {Photo credit: Tadeo Atuhura/MSH}Flora Mugisa receives incentives (porridge and milk) from the hospital team during a home visit.Photo credit: Tadeo Atuhura/MSH

As is the norm in the extended family support system in Uganda, Flora Mugisa helped care for her sister who was suffering from multidrug-resistant tuberculosis (MDR-TB). A year later, Flora also fell sick. She lost her appetite, grew thin, and complained of a heavy chest with severe pain. “I could not sleep at all,” said Mugisa, 70. “I would cough throughout the night. My grandson knew that I would die anytime.”

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