Treating TB during the time of Covid-19

Treating TB during the time of Covid-19• Community healthcare workers lead the way Community health workers are providing more home services to TB patients to reduce the number of visits these patients need to make to their local clinic. STAFF REPORTER

WINDHOEK



Tuberculosis (TB) causes more deaths than any other infectious disease in the world. Namibia has one of the highest TB infection rates in the world.

In 2018, it was estimated that 13 000 people fell ill with TB in Namibia; with over 5 000 undiagnosed.

This is particularly worrying during the time of the Covid-19 pandemic as both TB and the coronavirus affect the lungs.

As TB patients already have damage to their lungs, there is a risk that these patients will experience more severe breathing challenges if they are also infected with the virus.

In order to better protect TB patients from Covid-19, the Africa Centres for Disease Control and Prevention (CDC) in Namibia is supporting the health ministry to put measures in place to help reduce patient exposure to coronavirus infection in healthcare facilities.

Community health workers are leading these preventative measures by providing more services to TB patients where they live, reducing the number of visits these patients need to make to their local clinic. This reduces the chance of exposure to Covid-19 at healthcare facilities.



One-on-one care

The ministry has linked each TB patient to a specific community healthcare worker to ensure that every patient receives the care and support they need.

The community healthcare worker acts as a focal point for the patient, providing information, support and healthcare screening.

The community healthcare worker will also collect any medicines the patient may need from the clinic, again reducing the risk of exposure to Covid-19 for the TB patient.

If a TB patient does need to visit a healthcare provider, he or she will be asked to visit a smaller facility that should be less busy, which will help to maintain social distancing.

“Providing more services in the community is something we will continue post-Covid-19,” said Albertina Thomas, head of the national TB programme at the health ministry.

“The ministry was already scaling up community services and since the Covid-19 pandemic, we have worked hard to roll out these services faster.

“Community healthcare services are more convenient for patients who need medicine refills and other simple support services. Covid-19 has brought many changes and some of these changes are here to stay. Therefore interventions, such as digital technology to support TB treatment adherence, will be considered during the envisioned 'new normal'.”



HIV and TB

A further problem related to TB is the fact that HIV-positive patients are at increased risk of TB infection.

It is important to reduce this risk, particularly during this time.

Another Covid-19 preventative measure the ministry is undertaking is to prioritise the identification of HIV-positive patients who need to take a course of TB preventive therapy (TPT), a medicine that reduces the risk of TB infection.

All HIV positive patients should take this medicine for a period of six months to reduce the risk of TB infection.

In another effort to minimise visits to clinics, HIV-positive patients are now provided with the full course of TPT medication when they start the course.

Another development is that a new version of this medicine will be introduced in Namibia by the health ministry later this year, which only needs to be taken for 12 weeks.

This will be much more convenient for patients, making it easier to complete the full course.



Preventative medicine

Community healthcare workers are also working hard to identify other people who should be given TB preventive medicine. For example, if a person with TB is living in a household with children under the age of five, these children will also be given this medicine.

Again, this will help to protect those who are more vulnerable to Covid-19 infection.

“We are doing everything we can to reduce exposing vulnerable groups to Covid-19 infection.

“HIV-positive patients can do their part by asking about TPT if they have not yet been given this medicine, and when they are given the medicine, by making sure that they take the pills every day for the whole six-month period,” said the CDC country director, Dr Eric Dziuban.

By reducing the risk of TB infection, HIV-positive patients will also help protect themselves from developing the most severe coronavirus symptoms if they catch the virus, he added.