Communities Leading the way in Ending TB

Nestled in the north-eastern part of Uganda lies Karamoja, a region cloaked in semi-aridity and entrenched in poverty. Here, access to primary healthcare facilities is a distant reality for the majority, with a mere 17% of residents having such services within a 5-kilometre radius.

In 2019, the staggering revelation from Uganda’s Ministry of Health painted a dire picture: Karamoja, home to an estimated 1.2 million people, bore the highest burden of Tuberculosis (TB), clocking in at an alarming rate of 500 cases per 100,000 individuals, dwarfing the national average of 154 cases per 100,000. More disheartening was the statistic that only half of the TB patients completed their treatment, with a paltry three out of ten achieving a cure.

Life in Karamoja revolves around communal living within confined homesteads known as manyattas. Ten or more family members often share cramped, poorly ventilated shelters, creating an environment ripe for the transmission of TB.

Recognizing the formidable challenges in delivering TB services, the Infectious Diseases Institute, funded by USAID, implemented the Programme for Accelerated Control of TB in Karamoja (PACT-Karamoja) to tackle this airborne menace through a tailored community-based strategy. Since 2020, community members have been trained to identify potential TB cases, collect samples for testing, and support diagnosed individuals in adhering to treatment regimens and medical appointments.

Simon Peter Lobong, a dedicated community healthcare worker, shares, “Many misconceptions about TB prevailed here, equating it with AIDS. Our role extends beyond identification; we dispel these myths, building trust through active listening and maintaining utmost confidentiality.”

Remarkable progress has been made since the inception of PACT-Karamoja. Notably, the latest data showcases an 80% cure rate for TB patients, a substantial surge from the initial 52% success rate at the program’s outset. This improvement owes much to the community-driven approach bolstered by IDI’s innovative Call for Life smart solution.

In a region burdened by high TB prevalence and historically low treatment success rates, these strides mark a significant milestone. Mortality rates for Call for Life patients stand at 2.4%, notably lower than the 3.4% observed for long-term-follow-up (LTFU) patients.

Tuberculosis remains the world’s deadliest infectious disease, claiming 1.5 million lives annually among the 10 million infected globally. Despite its severity, TB is both treatable and curable, evidenced by the preservation of over 63 million lives globally through targeted interventions over the past two decades.

The USAID’s PACT-Karamoja program, a $7.5 million commitment spanning from 2020 to 2025, endeavors to combat Karamoja’s high TB prevalence and low treatment success rates. By nurturing locally-driven solutions, the initiative mobilizes health facilities, village health teams, and community members, fostering accelerated screening, testing, identification, and successful treatment and prevention of TB.

USAID’s PACT-Karamoja programme is a $7.5 million agreement (2020-2025) that aims to address the Karamoja Region’s high TB prevalence and low treatment success rates by supporting locally generated solutions to mobilize health facilities, village health teams, and community members for accelerated screening, testing, identification, and successful treatment and prevention of TB.

In Karamoja, hope flickers brighter as communities unite to eradicate TB, setting a resounding example for the world in combating this formidable global health challenge.