A Door-to-Door Campaign in Democratic Republic of the Congo Convinces Residents to be Tested and Treated for TB

 {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.”

DRC ranks among the 22 countries with the highest burden of tuberculosis (TB). Despite the efforts of the National TB Program, case notification is only about two-thirds of expected cases, and it dipped another four percent between 2010 and 2011.    

Funded by USAID and led by MSH, the Challenge TB project is assisting the Ministry of Public Health’s National TB Program to meet its target of detecting over 70 percent of expected, microscopy confirmed, pulmonary TB cases, treating TB, and coordinating TB/HIV treatment.    

But how do you find and treat TB patients in a place where illness is stigmatized, people believe the ill are cursed, and most avoid clinics in favor of local “healers”?

Challenge TB assisted the National TB Program to take this task head on. In April 2015, the project organized an intensive training for 60 community health workers in Kisenso and Mont Ngafula health zones, showing them outreach techniques, then sending them door to door to collect sputum samples from people who were visibly ill. The health workers, with staff from local nongovernmental organizations and supplies from Challenge TB, conducted a “mini-campaign,” visiting 1,632 households in four days. They collected 2,122 sputum samples, sent them for laboratory analysis—and discovered 12 people with TB.

As for Kelende?

“I refused to give a sample, telling myself I couldn’t have TB,” he said. “But they came back later and said they could help me, and it would be free. Finally I accepted. When the sample came back positive, I immediately went on treatment for two and half months. And now I feel well.”