Sample Collection and Transportation System Enables Non-Diagnostic Health Centers to Diagnose TB

Staff from a medical team at Gerems Health Center who were trained by HEAL TB to identify individuals with TB symptoms and refer them to a health center for treatment. {Photo credit: Dr. Kassahun Melkieneh/ MSH.}Photo credit: Dr. Kassahun Melkieneh/ MSH.

Twenty-two-year-old Melkamu Belete was misdiagnosed and left without proper treatment for six months. Although Melkamu had visited four health facilities to be treated for a cough, fever, and loss of appetite, the health care staff did not test him for tuberculosis (TB). Instead, each facility sent him home with antibiotics that did not heal him. Despite worsening symptoms, Melkamu eventually gave up and stopped seeking medical advice.

Eventually, Melkamu’s younger sister, Yelemset, began complaining of similar symptoms. With the help of relatives, Yelemset traveled to the Kuy Health Center, where she was diagnosed with TB. After placing Yelemset on TB medication, the team at Kuy Health Center notified the staff at their partner facility, Gerems Health Center, that Yelemset was being treated for TB. A health worker from Gerems followed up with Yelemset in her home and screened her family members for TB: finally Melkamu had a proper diagnosis.

Though Gerems Health Center does not have diagnostic capabilities, they, along with 14 other non-diagnostic health facilities in East Gojam Zone, have been part of a sputum sample collection and transportation project supported by the PEPFAR-funded, USAID project, Help Ethiopia Address the Low TB Performance (HEAL TB), led by Management Sciences for Health (MSH). This initiative allows health facilities without microscopes to send samples to facilities with microscopes for testing: a low–cost and life-saving solution.

Today, Melkamu’s health has improved significantly. “I was desperate and about to stop going to school [because I was so ill]. I am glad that I started treatment. I am now strictly following my medication,” said Melkamu.

Since the transportation initiative started in April 2012, HEAL TB has provided clinical TB training for nearly 300 health care providers in East Gojam Zone of Amhara regional state. Fifty-eight of these health care providers were from the non-diagnostic health centers. Over 10,000 clients have been screened for TB at health facilities and through home visits in Amhara.