Health Worker Trainings and Advocacy Activities Improve TB Patients' Nutritional Status and Treatment Adherence

 {Photo credit: Rita Tumuhairwe/MSH.}Nile Breweries donated 36 cases of water to TRACK TB-supported hospitals. Purified water helps TB patients stay hydrated during treatment. Photo credit: Rita Tumuhairwe/MSH.

Nagayi Efrance became infected with tuberculosis (TB) in 2012. Although she attended local health facilities for treatment, the TB medicine did not heal her and often left her feeling nauseated and unable to eat. When Nagayi tried to take the TB medicine on an empty stomach, she felt even worse. Eventually, she stopped taking treatment and developed multidrug resistant TB (MDR-TB), a strain of TB that cannot be treated by first-line anti-TB medicines.

By the time Nagayi arrived at Mulago Regional Referral Hospital for treatment, she was severely ill and malnourished.

Because TB medicine often causes nausea and loss of appetite, malnutrition is common among TB patients and can cause poor treatment adherence and prolonged illness. As in Nagayi’s case, treatment default also makes patients more susceptible to MDR-TB.

In response, the PEPFAR- and USAID-funded Track Tuberculosis Activity (TRACK TB) project, led by Management Sciences for Health (MSH) with partners, trained 100 Ugandan health workers from six regional reference hospitals to manage MDR-TB patients and effectively treat TB patients with nutritional deficiencies.

TRACK TB also advocates with the private sector for food, water, and financial donations to help support the patients. As a result of this advocacy, TRACK TB has raised 17,195,000 Ugandan shillings (over US $6,700) in food and cash donations to project-supported health facilities since July 2013. The donations of milk, water, and porridge help the patients stay hydrated and nourished so they can regain their strength and better adhere to TB treatment. Said Nagayi:

I really appreciate the… milk, water, and porridge. I can now take all my medicine without an empty stomach. I have gained weight and I can now tolerate my medicines even better.

Dr. Charlotte Ongom, the MDR-TB focal person in the TB ward in Mulago Hospital, has been pleased to see how these interventions are helping her TB patients recover. She said:

The food we receive from TRACK TB puts a smile on all the patients and they are really grateful… many of the patients have put on weight. It has improved their attitudes.

Since July 2013, over 100 patients at Mulago Hospital have benefited from the staff training and food and drink donations.

TRACK TB is now conducting similar health worker trainings and corporate advocacy activities at the regional referral hospitals in Kitgum and Mbarara. In the coming years, TRACK TB will also train health facility staff to conduct corporate advocacy activities so they can become more financially stable and self-sufficient.