Community Mobilizers Help Control TB in South Sudan

 {Photo credit: Emmanuel Kenyi/MSH}David Kolang leads a community awareness session on TB.Photo credit: Emmanuel Kenyi/MSH

The World Health Organization (WHO) estimates prevalence for all forms of tuberculosis (TB) in South Sudan to be 146 for every 100,000 people. Based on that estimate, the country’s national TB program said it was notified of only 39 percent of all forms of TB cases in 2013, and of those cases treated in 2012 only 52 percent successfully completed treatment compared to the WHO’s target of 85 percent.¹ These low levels are attributable to a lack of awareness of TB at the community level and inadequate follow-up mechanisms by health care providers for patients already on TB treatment and tracing their contacts.

To address these challenges, the TB CARE I project trained 240 community mobilizers from Yei, Lainya, and Morobo counties on how to identify TB symptoms, refer patients to the health facilities for diagnosis, and provide support to patients on TB treatment.  Through the dedication of this active group of mobilizers, 11,000 people were sensitized, 237 people were referred for diagnosis, and 19 were confirmed to have TB.

The Dutch nongovernmental organization KNCV TB Foundation led the project with partners WHO, Management Sciences for Health (MSH), and others. The US Agency for International Development (USAID) provided funding.

In Yei County, David Kolang serves as one of the young scouts dedicated to community mobilization.  On a visit to Hai Simba, Yei Town, in July 2014, Kolang met Moses Aketch, a 17-year-old high school student who had been suffering from a severe cough and runny nose for two years.  Despite many different medical treatments, his symptoms worsened.

Moses attended a presentation that Kolang carried out during one of his visits to the community. “David talked about the signs and symptoms of TB and had me go to Yei Hospital for examination,” Moses said. “I listened to him and went to Yei Hospital to meet the medical assistant. I was asked to produce thick sputum to be examined, and the results came out to be tuberculosis. On January 29, 2014, I started TB treatment.”   

Kolang provided support to Moses as he abided by the strict TB treatment regimen of three tablets per day over the course of approximately three months.  Moses started noticing positive changes in his body, including healthy weight gain and less coughing as a result of the medication.

[Moses Aketch, a beneficiary of the TB CARE I community mobilization program.] {Photo credit: Emmanuel Kenyi/ MSH, South Sudan}Moses Aketch, a beneficiary of the TB CARE I community mobilization program.Photo credit: Emmanuel Kenyi/ MSH, South Sudan

Reflecting on his experience with Kolang and the TB CARE I trained community mobilizers, Moses said:

God bless the scouts in their community TB service and the organization supporting them. They are doing it for the nation. It was the scouts’ awareness of TB that made me go for TB treatment. My message to those who are coughing like me: go for TB screening.

1. The national TB program receives notification from hospitals and clinics about patients who have been diagnosed, registered, and enrolled for TB treatment. The national TB program compiles the figures and reports them to the WHO. In this case, 61 percent of those estimated by WHO to have TB were not diagnosed or treated.