“I suffered with cough, body weakness and joint pain for a while and I thought it was malaria. I only confirmed that I had TB after going for screening” Gabriel Kubal, a resident of Lokodope village in Karenga district narrated.

Several people with tuberculosis (TB) in Karamoja do not know that they have the disease. National TB statistics indicate that over 89,000 Ugandans get infected with tuberculosis every year, surpassing the 50,000 who contract HIV annually.

With support from the American people, the United States Agency for International Development (USAID) Uganda partnered with Infectious Diseases Institute (IDI) in the USAID PACT Karamoja Activity to build local initiatives towards the reduction of the TB burden in the Karamoja region.

Karamoja region is one of the three areas in Uganda cited with a very high rate of TB spread. The region covers 9 districts that is Abim, Amudat, Kaabong, Karenga, Kotido, Moroto, Nabilatuk, Nakapiripirit and Napak. Due to the nomadic way of life of the people in this region, it is difficult to treat and follow up on TB patients as they move from one area to another, taking care of their livestock. As a result, this has led to an increase in spread of TB and a low rate of adherence to medication for people that were diagnosed with TB as well as an increase in the rate of spread of TB within the communities.

In an effort to address these challenges, the USAID PACT Karamoja is working with community-owned resource persons (CORPs) who were introduced at the start of the project, to provide TB screening services in high-burden parishes, support referrals from communities to the facilities and work with community leadership to support those on treatment to adhere to their medication.

Like many others, Gabriel was identified through active door-to-door screening by a CORP and then referred to the nearby facility where he was diagnosed with TB.

“There are many people within the villages that have been referred by their family and friends with symptoms of TB. Some are able to go to health centres for treatment however, others are afraid. They require encouragement to get screened and treated if diagnosed,” says Lolem Lucy, a CORP in Lokodope. Lucy works with Karenga Health Centre IV, reaching out to people with symptoms of TB or anyone referred within the villages. Lucy also educates the residents on ways to keep safe and support those that have the TB.

Over the last four months, the CORPs in the region have screened over 13,000 people in the communities. They have also encouraged many more to go for TB screening, taught community members the signs and symptoms of the disease as well as ways of supporting the sick people within the communities.

“I am grateful for the support I have received. Lucy encouraged me to go for TB screening at the health centre. I am currently in my third month of treatment and I hope to continue with my medication as required.” Gabriel says. He is one of the TB patients currently on treatment at Karenga HCIV enrolled through the CORPs.

Mentorship and coaching are regularly carried out by the district and USAID PACT Karamoja teams for healthcare workers such as medical workers, CORPs, Community linkage Facilitators (CLFs) to build their skills in clinical diagnosis, retention and commodity management in the region.

Dr Mary Mudiope, the Chief of Party, USAID PACT Karamoja, handed over 4 motorcycles to the district health leaders to ease transportation of district mentors over the long distances during the TB control activities within the region.

“Karamoja has had several issues concerning access to medicine, availability of commodities and more, but we hope that through this programme these gaps will be addressed, “she said.

USAID PACT Karamoja Activity is a five-year project (January 2020 to January 2025) funded by USAID. The project aims at scaling up evidence based and high impact interventions towards achievement of the End TB strategy targets of 90% treatment coverage and treatment success in all the 9 districts of Karamoja region of Uganda.

USAID partners with government, private and non-government sector to support critical systems that will help sustain a rapidly growing population and advance different sectors including the health sector so that all Ugandans have opportunities to thrive.

By Nakitandwe Rebecca Melisa