MSF Backs NLTCP in Decentralizing TB Care
The Medical Coordinator of Medecins SansFrontieres/ Doctors Without Borders (MSF), Dr Bukola Oluyide in an exclusive interview with the New Citizen Newspaper underscored their unwavering commitment to support the National Leprosy and Tuberculosis Control Program to decentralize TB care and further make it ambulatory.
She cited the ambulatory system as one which allows TB patients to go home and do follow up treatment once they prove that they are stable and there is no risk of transmitting the disease to others.
She stated that the MSF Test, Avoid, Cure TB in Children (TACTIC) global initiative, surveyed 14 countries this year on the implementation of the latest 2022 guidelines from the World Health Organization (WHO) to diagnosis, treat and prevent TB in children in which Sierra Leonewas among the countries surveyed. The result reveals that the country is 88% aligned recommended policies for diagnosis, prevention, and treatment of drug-sensitive and drug resistant TB in children.
Dr Bukola Oluyide furthered that TB has no typical symptoms in children and she called on health care workers to be guided by the algorithm and recommendations.
“Children can be treated for TB if healthcare workershave a high index of suspicion that the child might have TB,” she averred.
Dr. Oluyide asserted that they have supported the NLTCP with caring for patients living with TB in 15 Directly Observed Therapy (DOT) site in Bombali districts at primary health care facilities where children are beingtested based on the treatment decision algorithm chart andinitiated on treatment; also in the Makeni Regional Hospital, children who are admitted for other diagnose in the ward are also screened for the possibility of TB and if they share showing signs, they are also tested and initiated on treatment. Moreover, children who are living with parents or guardians who are diagnosed with TB are given Tuberculosis Preventive Treatment to immune them from being symptomatic.
After the implementation of the new diagnostic tools, the number of children under the age of 15 enrolled for treatment in the district’s drug-sensitive TB programme increased substantially from 163 in 2020 to 384 in 2023.
Alimamy Sesay, a community health worker for the Ministry of Health at the Makeni Regional Hospital, says in the past, many children were misdiagnosed and treated for pneumonia or other lungs infections. A reason why they often fell ill again and return to the hospital, while some lost their lives. When they started diagnosing the children using the clinical decision algorithm chart and provided them with anti-TB medication, “we began to see great improvement in their health and a quicker recovery,” he noted.
Due to the high difficulties in confirming TB in children, one of the recommendations of WHO is for health care workers to conduct TB treatment in children if they are showing symptoms based on clinical criteria, using the treatment decision algorithms. The guidelines also encourage testing of stool or urine samples, which are more efficient in diagnosing TB in children as opposed to sputum testing, which is used for adults.
Dr Bukola Oluyide calls on international partners and donors to support the Ministry of Health in Sierra Leone financially and operationally in ensuring a nationwide roll-out and implementations of these guidelines in primary and secondary health care facilities. She further referenced the successes in Bombali district as a testament of the efficiency of the guidelines and further averred that more children will be diagnosed, treated, and prevented from TB if support is given for its implementationnationwide.
