- Well, there are two possible assumptions, one could be that I always encounter a biased group, but it is quite unlikely because such encounters occur randomly and sometimes begin from unrelated conversations. Second, TB is not popular among non-medics. In my opinion, the second assumption is potentially the most reasonable one that needs some reflection.
I have encountered a common question during my discussions on tuberculosis (TB) with ordinary people [not in the medical field], ‘Is TB still a problem?’ This has always left me puzzled. I keep asking myself how could it be possible that people in one of the very high TB burdened country know little about the disease.
Well, there are two possible assumptions, one could be that I always encounter a biased group, but it is quite unlikely because such encounters occur randomly and sometimes begin from unrelated conversations. Second, TB is not popular among non-medics. In my opinion, the second assumption is potentially the most reasonable one that needs some reflection.
The link between poverty and TB
Let us begin by asking ourselves, who gets TB? I will not focus on biological and clinical factors, rather talk about socioeconomic factors which have been linked to the disease.
TB commonly affects the poor people in the society. They are those who specifically have material poverty. Those who can hardly afford good housing and end up in slums with poor ventilation and congestion, those who can hardly afford a balanced diet and end up being victims of malnutrition and those with low income who generally have unstable employment.
This means that there’s a strong association between poverty and risk of getting TB. Of course there are other risk factors such as being immunocompromised with HIV.
My concern is on how many of our people actively engage in the fight against TB. We have not fully engaged as a community to seriously not just talk about it but develop interventions which originate from the community to address this disease. There is a general feeling that TB is no longer a problem or less of a concern.
The World Health Organisation (WHO) recommends community engagement in reducing TB transmission. This is well reflected by the National TB and Leprosy Programme through the adaptation of the engage community TB model. These efforts are highly commendable but until the community feel they are part of this struggle, we are yet to fully realise impact of all these proposed interventions.
The fight must start at the family level, schools, local government as well as media. In all these levels, TB must be discussed in terms of risk of transmission, symptoms, early health seeking behaviour, treatment adherence and prevention.
The community should be well educated on all aspects but also motivated to fully engage in seeking healthcare when TB is suspected. At schools, students should form educative clubs such as TB-awareness clubs, which will play a role in bringing awareness to not only within the school environment but also back in the community. The media has a very strategic role to play but also having regular sessions on TB should be planned, which are geared to bring more awareness to the community.
The world has set up ambitious goals of ending TB by 2030. This reflected in our national TB strategic plan. The National TB programme wants to increase TB detection. Our country is still highly burdened by TB. As we head towards the ‘end TB 2030’, our efforts in the fight must double and be above the average.
A healthy society stands a better chance of socio and economic prosperity. As much as we reform our country to a better future, the need to fight chronic diseases such as TB cannot be overemphasised enough.