TB treatment makes a difference

The directly observed treatment programme is improving the lives of TB patients, especially in northern Namibia.

31 August 2017 | Health

Good primary healthcare is critical, but due to limited resources, retrieving treatment for diseases like tuberculosis has been an ongoing challenge for those suffering from the sickness.

With the help of directly observed treatment (DOT) points, this has eased the struggle and patients under TB treatment have made recoveries.

Namibian Sun visited the country's first DOT point at Oshikango, on the border of Namibia and Angola.

These centres have rung in change and one of the healthcare workers explained that Angolan citizens are also helped.

“Since we are so close to the border, we also have Angolan citizens coming in here to receive treatment. We cannot send them away.”

The TB-DOT health centres in Namibia are funded by the American government through their President's Emergency Plan for Aids Relief (Pepfar) programme and the United States Agency for International Development (USAID).

The Dutch KNCV Tuberculosis Foundation, along with the health ministry are responsible for the implementation of the programme.

“Current data shows a downward trend in TB cases and an upward trend in TB-treatment success rates. That is good news, but it is critical to continue to provide comprehensive TB and HIV services in Namibia,” said US Ambassador Thomas Daughton at the Challenge TB Milestone event held earlier this year.

TB is a common airborne disease that affects all that are exposed to the bacteria.

In Namibia, TB and HIV co-infections are common and the diagnosis of one often leads to the other.

According to the health workers at the DOT centre in Oshikango, if a patient comes in with TB-like symptoms and they are tested positive for the disease, he or she is also advised to be tested for HIV.

Residents have applauded the US government for bringing the two services together under one roof.

In addition, a load has been lifted from the hospitals around the district as nurses and doctors now deal with fewer patients.

The DOT stations were set up to monitor the progress of patients under treatment as they are required to be under constant supervision.

“The patients receive their treatment daily at the DOT points, so we try our best to make sure we follow up with all our patients,” added another health worker.

Gottlieb (not his real name) has been on treatment for six months after he tested positive for TB at Engela District Hospital.

“I started my treatment there, but due to the distance, I stopped. I was supposed to finish my treatment, but I defaulted and the treatment stopped working,” says the 31-year-old farmworker at a village close to the border.

“When I used to go for treatment in Engela, I would have to use transport money and I am just a farmworker so I do not make a lot. This centre has really helped me,” he explained.

The second DOT centre Namibian Sun visited is in Tsumeb's Kuvukiland informal settlement.

Reaching out to the poor

Before the establishment of the DOT centres, these patients also had to walk long distances to get to the hospital.

According to Sylvia Haoses, the Tsumeb district TB and leprosy coordinator, many patients forfeited their treatment, in turn causing an increase in the spread of the disease.

“After the implementation of these centres, I can say I have seen a decrease in defaulted cases,” she said.

What started off as a dumping site with no water or electricity, the DOT in Kuvukiland has helped improve the lives of many including that of Hendrich Khaibab.

After he was diagnosed with TB last year, he started with his treatment every morning at the centre.

“I do not struggle at all to get here as it is close to where I live,” said the 46-year-old.

Haoses continued saying the number of patients with TB who had defaulted on their medication in Kuvukiland has been radically reduced from 21.5% to 7.6%.

“I can say with pride that the DOT centres contributed to this decline as more than 6 000 people stay here. We also have other informal settlements that come here and make use of our services.”

The clinic is operational from 07:00 to 16:00 so patients like Khaibab who start work at 08:00 are granted the opportunity to take their medicine.

Informal settlements are often overcrowded and poor sanitation is a nationwide problem.

Haoses said that this is a contributing factor to the high rate of TB in Kuvukiland.

“The shacks do not even have any windows so that worsens it.”

To date, 45 DOT points have been set up in eight regions.

From 2005 to 2015, they have been able to successfully treat 80% of the TB/HIV co-infected patients.

With plans of expanding these centres, a target of 100% of Namibians co-infected with HIV and TB will have access to these services by 2019.


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