Improving Tuberculosis Detection in Democratic Republic of the Congo

Nurse Mpala Muhungu in Lubudi, with two children diagnosed with TB following the DRC-IHP training. {Photo credit: MSH.}Photo credit: MSH.

Nearly one in two cases of active tuberculosis (TB) went undetected in the Democratic Republic of Congo in 2010, due to inadequate screening for the disease. In the province of Katanga, the health zone of Lubudi has low detection rate, which is attributed to a lack of involvement from community health volunteers in identifying local TB cases.

Under the USAID-funded Democratic Republic of Congo-Integrated Health Project (DRC-IHP), led by Management Sciences for Health with partners the International Rescue Committee and Overseas Strategic Consulting, efforts are underway to improve the basic health conditions of the Congolese people in 80 health zones in four provinces, including increased care and treatment of tuberculosis (TB). Recently, DRC-IHP offered training in the “Directly Observed Treatment, Short-Course” (DOTS) approach – the globally endorsed approach by all major health organizations – for health workers in Lubudi health zone.

The goal of the training was to strengthen the capacity of 32 health service providers and 59 community health volunteers, who serve a population of about 105,200 people. Through this training, 12 health facilities with trained health workers became designated centers for detection and treatment of TB, while the community volunteers were enlisted to provide support for transportation of sputum samples – part of the diagnostic test for TB – from villages that were distant from the health centers.

At the conclusion of the formal training, participants were sent out to remote villages, to verify their capacity to correctly detect and identify TB cases. Seven kilometers from Lubudi, community health workers identified two young children who were likely infected with TB, a 20-month old and a 6-year-old. After sputum testing positively confirmed their illness, the children were able to begin treatment.

‘‘This is the first time we have been able to have good results from a sputum smear in a timely manner. To be able to immediately screen two cases during the period of our field testing was an excellent result,” said Dr. Robert Kabesya, the chief medical officer of the health zone. “We thank DRC-IHP for this support.’’

DRC-IHP is now supporting additional TB trainings in other health zones to strengthen the DOTS approach and integrate TB/HIV services.