A total 7,317 new Tuberculosis (TB) cases were detected in hard to reach population groups since the year 2019 through the Kunda-Nqob’iTB (KN-TB) project, a community centred TB research and case detection model being implemented in Zimbabwe.
By Michael Gwarisa
The KN-TB program is a five year United States Agency for International Development (USAID), Tuberculosis Local Organization Network (TB-LON) funded project running from 2019 to 2024. The project is supporting the national TB-HIV response in Zimbabwe in eight high burden districts across three provinces. The eight target districts are Gweru, Gwanda, Zvishavane & Insiza, Shurugwi, Chirumanzu, Kwekwe and Mwenezi.
The KN-TB project is being implemented by the Union Zimbabwe Trust (UZT) through its local consortium partners, Baines Occupational Health (BOCH), Jointed Hands Welfare Organisation (JHWO) and HOSPAZ.
Speaking to Journalists at the just ended Kunda-Nqob’iTB (KN-TB) Media Orientation on TB Control workshop in Kwekwe, Dr Sithabiso Dube, Technical Director, the Union Zimbabwe Trust (UZT) said they had recorded impressive milestones in the National TB response since inception of the KN-TB program.
KN-TB has contributed to the detection of 7,317 TB cases since 2019. In the districts where we are, these are the numbers that have come out. We do not work as a Silo, we are supporting the Ministry of Health and Child Care (MoHCC). The projects districts contributed 16% of the National TB Notification. The project is being implemented in the districts that were not doing well all before and we are really seeing the improvement,” said Dr Dube.
The KN-TB grant has a Buy in of US$15 Million. It started in 2019 and ending in 2024 in eight high burden districts. These are districts with poor outcomes, meaning when people get TB there, they most likely do not get better. Its either they are dying or some of them are loss to follow up. Others may not be even recorded that they had TB.
“We also looked at districts that have high concentration of artisanal miners. These do not normally seek care in health facilities. We wanted to make sure that we can reach them and also screen them. We found that using this target population screening, our yields has improved and we are now finding more and more of those missing cases using both the outreach and clinical approach.”
Since project inception 14,227 Specimens transported; 4,420 were TB specimens, Contributing to 263 diagnosed TB. Contact investigation has contributed to detection of 197 TB cases from 11,416 contacts screened since project inception. Cumulatively, 5,635 artisanal and Small Scale Miners (ASMs) screened 364 (6%) diagnosed TB; 901 (14%) with Silicosis & 543 (10%) with HIV since project inception,” said Dr Dube.
Meanwhile, giving an overview of the National TB and Leprosy Control Program, Dr Mxolisi Ngwenya from the Ministry of Health and Child Care (MoHCC) AIDS and TB Unit said apart from TB screening and detection in Zimbabwe, the improved diagnostics has resulted in enhanced dual detection of TB and HIV.
“We have adopted what is known as ITHC, that is Integrated TB and HIV Care. You will notice when you get to a clinic. Whatever clinic, think of any clinic you have been to. You find that there where they are doing TB screening, that is where that are also doing HIV. We are saying the moment we suspect you that you have TB, we test you for HIV. The moment we also suspect that you have HIV, we screen you for TB because these two diseases move side by side. This has been so successful because now we know the HIV status of 99.9% of people with TB in Zimbabwe,” said Dr Ngwenya.
He added that even though Zimbabwe has made significant strides in the TB response, some challenges were still standing in the way.
“TB programming was severely impacted by Covid 19 – stigma, access, health workforce attrition Rapid catch up plans required with a focus on community based interventions, high quality screening in PLHIV and facility based ICF. New players and partners continuously need to be mobilized and engaged to bolster the national response.”
Zimbabwe has since been moved from the world’s top 30 list of countries heavily burdened by TB. It now has a double burden of TB/HIV and MDR-TB. Zimbabwe has a HIV prevalence of 12,9% (ZIMPHIA, 2020) HIV Prevalence: 11.8% (15-49 age group) -Female 14.8% -Male 8.6%.
