Did you know that the risk of you getting Tuberculosis has now doubled? A recent study by the Tuberculosis working to empower the nation’s diagnosis effort TWENDE conducted in 2016 and 2017 shows that the number of people living with the infection is almost twice compared to the statistics presented in the 2015 report by the World Health Organization and the Global Fund. “The prevalence rate of TB in Uganda is much higher than was originally thought when Uganda was removed from the high burden countries. So for example; right now the current prevalence rate is estimated at for every 100,000 people, 253 are infected with TB.” Said, Norah Owaraga – Managing Director, CPAR Uganda. And this prevalence in particular for the pulmonary Tuberculosis.

TB is a bacterial infection that attacks the lungs acquired through droplets from the coughs or sneezes of an infected person. It is one of the top ten causes of death worldwide. The standard symptoms of TB disease include; a chronic cough with sputum containing blood, fever, night sweats, and drastic weight loss. The TWENDE study was carried out countrywide and also took into account of the available data. But if the previous studies read Uganda high burden, why then have the numbers doubled? “There is data that is linking TB to HIV & AIDS and there is insufficient data that looks at TB alone in terms of if this person has TB and doesn’t have HIV and that is probably one of the reasons why we are not listed on the high burden countries. The obvious signs of TB do not manifest until such a time that the disease has already taken significant effect.”

An estimated 89,000 people get TB disease every year. The survey showed that almost half of all the cases go undetected exposing more people to infection since they are less in trying to seek treatment. Owaraga says stigma is still the biggest hindrance in the fight against Tuberculosis. “You find that when someone finds out that they actually have TB; they have tested and they have confirmed that they have TB, seeking treatment becomes something that you hide. You don’t want people to know that you are on TB treatment. And so even though the government has tried as much as possible to decentralize administration of TB Medicare, people leave drugs in the lower centers and want to come to a center where they are not known.”

“...for Uganda and for the rest of East Africa, around 60% of the TB patients don’t have HIV and because the community is not aware and they generalized and associated HIV & TB, that has now created a lot of stigmas.” Said, Dr. Wilber Sabiiti – Chairman, TWENDE Consortium. “And some of them because of that they are not completing their medication. And with TB if you don’t complete the medication, TB can sort of transform and become what they call Multi-Drug Resistant TB. The Multi-Drug Resistant TB is harder to treat.” The Health Ministry, however, provided the Gene Expert machines to all Referral Hospitals which are vital in detecting different types of TB between Ordinary, Multi-Drug Resistant and Extra Resistant. But, Dr. Wilber Sabiiti who leads the TWENDE Consortium says there are inefficiencies even with the availability of such machines. “We found that in Uganda, only 12 Hospitals conducted 8 tests per day; that is 160 tests per month. So those are the one that utilizes the Gene Expert to full capacity. So the rest did not achieve that full capacity.”

The researchers also developed recommendations for the government and the Health Ministry. They urged policymakers to increase funding towards eliminating Tuberculosis and the Health sector generally. “Uganda contributed only 3% towards the control of TB budget for 2017. These diseases are our problems, they are not Britain’s or America’s problems.” “We have already submitted two policy briefs to the Health Committee of Parliament and the two policy briefs one of them is encouraging the Members of Parliament to look at budgeting and financing for TB and we hope that it will be one of the policies that will influence the 2018 budget.” Uganda’s Health Budget still remains one of the least funded regionally with the budget allocation of less than 7% as compared to the global recommended 15%.