Support to TB Management in IDP camps in northern Uganda

Situation:

Nearly two decades of conflict have displaced up to two million people, of whom 90% are still living in internally displaced people (IDP) camps without adequate resources. The districts of Gulu, Kitgum and Pader confirmed that the crude and under- five mortality rates are well above their respective emergency threshold (1/10,000 and 2/10,000/day) at 1.54 per 10,000 and 3.18 per 10,000 per day respectively. High rates of TB have been present in these districts due to massive internal displacement, overcrowding and poor socioeconomic circumstances as well as a higher than national average of HIV-AIDS. Nearly one million IDPs are estimated to have little or no access to basic health care. Congested and over-crowded camps provide squalid living conditions. Disease outbreaks caused by limited water supply and poor sanitation contribute to the increased morbidity and mortality rates. Children and women, who represent 80% of IDPs, are the most vulnerable group.

Response:

Whilst the bulk of the Malaria Consortium's work is on malaria, we are also active in the fight against tuberculosis. In Uganda, we have significantly strengthened the capacity of 4 districts in the war affected areas of northern Uganda to provide quality treatment for tuberculosis patients. We have improved access to TB treatment by setting up 53 new treatment centres. We are also giving support to data collection from most TB treatment centres in these districts. This was achieved through training of health care workers on improved case detection of suspected TB sufferers, on treatment, case referral and improved quality of TB diagnosis. 

Points to note:

This work needs to continue as it has already contributed to significant rises in case detection rates in two of these districts. 

The model should also be extended to other districts of Uganda which are currently showing very low levels of TB case detection rates.

It is important to work in close partnership with the district health teams to increase their capacity and to ensure sustainability.

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Photo: William Daniels