Tuberculosis (TB) cases have increased in Zambia, according to a Ministry of Health report released on World TB Day in 2008. Zambia is one of the countries with the highest prevalence of TB in the world and about 70% of detected TB cases are co-infected with HIV.
Cases have increased from around 100,000 in 1984 to 523 per 100,000 in 2005, which shows a huge increase. In 2004, the government managed to cure 75.6% of all the infectious cases of TB registered in the previous year. However, this fell short of the target, which was to have a cure rate of 85%, in accordance with the Millennium Development Goals (MDGs) and World Health Organization (WHO) targets.
Cases of TB have continued increasing in Misisi Township, an informal settlement, due to high poverty levels. In July this year (2011), 267 TB referrals were made in Misisi and Chawama, while in Kabwata and Libala, 167 TB referrals were recorded.
Maria Phiri (name changed), aged 34, is co-infected with TB and HIV. She discovered her HIV status five-years-ago when her husband divorced her. In April this year, she developed symptoms of TB; a dry cough that lasted more than three weeks. At first she ignored the cough but later on lost her strength and could no longer go out to do piece works in the surrounding Kamwala Township. The money she raised from piece works had enabled her to feed herself and her ten-year-old son and also pay for the one-room apartment she was renting in Misisi Township.
She became very sick but continued to look for piece works, dragging her frail body with a walking stick, a sight which made many people look on in shock.
Victoria Kangwata, a treatment supporter, decided to visit her and met Maria’s son. Treatment supporters are volunteers who are trained to provide counselling and support to people living with serious health issues such a TB. Victoria asked the boy where he was going and he replied that his mother had sent him to buy Rogo (rat poison). Immediately, something clicked in Victoria’s mind and she rushed to Maria’s home where she found Maria weeping. Maria confessed she wanted to end her life as she could no longer carry on. Victoria counselled her and suggested that they go to Kamwala Clinic where examinations were conducted on her sputum. As these results tested positive she was commenced on TB treatment.
When I visited her home last week, she was all smiles and told me that she owed her life to Victoria as she would not be alive today. She says Victoria gave her both moral and spiritual support.
Maria now encourages others to go for tests as soon as they develop symptoms of both HIV and TB.
The involvement of communities in any health program cannot be over-emphasised. In the case of Zambia, which accounts for a high percentage of HIV/TB co-infections, the community plays an important role in the early TB case detection.
