tuberculosis

Women, men and children stand in line at the St. Joseph's Health Center in Abricots, Haiti. {Photo credit: Gumy Dorvilmar/MSH.}Photo credit: Gumy Dorvilmar/MSH.

It was 11 o’clock one February morning when the Santé pour le Développement et la Stabilité d’Haiti (SDSH) project technical team arrived on site at St. Joseph Health Center.

The center’s activities were well underway. Dozens of people sat on benches or stood in line, waiting for their turn. One person comes to care for her child who has had a high fever. Another comes for contraception. Another just gave birth to a healthy infant.

St. Joseph Health Center is located in Abricots, a remote community in the department of Grande’Anse, Haiti, far from Port-au-Prince. Abricots is nearly inaccessible because of rough terrain and hazardous mountain trails.

Since 2007, with support from the USAID-funded SDSH project, led by Management Sciences for Health (MSH), St. Joseph Health Center has provided a basic package of health services: pediatrics, maternal health, reproductive health, detection and treatment of sexually-transmitted infections, HIV/AIDS, tuberculosis (TB) and family planning.

This free clinic is the only health institution in this hard-to-reach area, serving an estimated 32,000 people.

Voices of TB participants (from left): David Rochkind (moderator); Rachel Urduno (Mexico/Texas); Andre Gariseb (Namibia); Pham Thu Hoa (Vietnam); Francis Apina (Kenya); Rosalie and Faith Stephson (Philippines/Texas); Endalkachew Fekadu Demmisse (Ethiopia). {Photo credit: Claire Moodie/MSH.}Photo credit: Claire Moodie/MSH.

Cross-posted on TB-CARE I.

World TB Day, March 24th, was commemorated in many countries around the world last week to acknowledge the accomplishments made in the fight against tuberculosis (TB), and to call attention to the work that still needs to be done.

Voices of TB, a unique event organized by USAID, featured former TB patients speaking about their personal fight against TB. Survivors of TB from Ethiopia, Kenya, Namibia and Vietnam --- four TB CARE I-supported countries --- and from the United States, spoke at the event on March 22 in Washington, D.C.

Originally known as SITE-TB, Sistema TMBR is the official platform for drug resistant TB monitoring and treatment in Brazil.Originally known as SITE-TB, Sistema TMBR is the official platform for drug resistant TB monitoring and treatment in Brazil.

In the 1990s many Brazilian patients infected with tuberculosis (TB) were not being cured, despite starting treatment. Some patients stopped taking their medication, which led to the reemergence of TB. In 1993, the World Health Organization declared that TB was a global emergency. Eventually, a multi-resistant strain of TB surfaced, making it even more difficult to fight the disease.

These occurrences --- referred to as “chronic cases” --- became apparent in some Brazilian states, but health units lacked standardized management systems to treat these cases of TB.

Centro de Referência Professor Hélio Fraga (CRPHF), which is Brazil's National Tuberculosis Reference Laboratory, took control of TB surveillance in 1994. CRPHF defined a more effective treatment scheme and a national network to register and monitor the chronic cases in 1999. CRPHF builds human capacity through training and carries out operational and epidemiological studies. They also evaluate TB and other lung disease control activities and function as a Macro Regional Reference Lab.

Cross-posted from the K4Health Blog.

As the mHealth Summit gets underway this week in the Washington D.C. area amid thousands of mHealth projects taking shape around the world, one particular mobile activity is saving lives by helping to ensure that the contents of medicines match their labels.

The Problem:

According to a  2010 World Health Organization Fact Sheet, it is difficult to estimate the percentage of counterfeit medicines in circulation—WHO cites estimates in industrialized countries at about 1%, and adds that “many African countries, and in parts of Asia, Latin America, and countries in transition, a much higher percentage” of the medicines on sale may be falsely labeled or counterfeit.

The images of tuberculosis patients from the developing world are often painful to look at: the outlines of rib cages taut against skin; arms and legs no thicker than wiffleball bats; a wild-eyed look of fear from sunken eyes. But the image of Mildred Fernando, captured here by photographer Riccardo Venturi, turns heads toward her.

Mary's 120 square foot house, purchased in 1992 (Mala Persaud/GHARP II)

Mary* was married at the young age of 13 in her hometown, Crabwood Creek, Region 6, Guyana. At age 15, after she gave birth to her first child, her husband deserted them. Mary was left to provide for herself and her child. She tried a few odd jobs, but they did not work out. In 1989, at age 15, she turned to commercial sex work. At this time, Mary had never heard of condoms and had never used one. Her earnings were adequate, as much as $300 some weeks. However, heeding the advice of many of her older friends, she chose to leave sex work in 1992, spent her savings on a 120 square feet house, and started fishing to support herself and son.

The World Health Organization (WHO) recently endorsed a new and novel rapid test for tuberculosis (TB), especially relevant in countries most affected by the disease, and is calling for widespread use of this test and its incorporation into national plans.

MSH applauds the research and development experts who developed this new TB test and the WHO for endorsing it so quickly. The test could revolutionize TB care and control by providing an accurate diagnosis in less than two hours, compared to current tests that can take up to three months to produce results.

Evidence suggests that use of this test could result in a three-fold increase in the diagnosis of patients with drug-resistant TB and a doubling in the number of HIV-associated TB cases diagnosed in areas with high rates of TB and HIV. Finally, the test is easy and safe to use and also allows for testing in non-health facility settings, including in people’s homes.

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