This Monday, March 24, World Tuberculosis Day (TB), is an opportunity to raise awareness about TB-related problems and solutions and to support worldwide TB control efforts. The US Government in Haiti has supported tremendous progress related to diagnosing and treating TB. For example, HIV patients supported through the PEPFAR (President's Emergency Plan for AIDS Relief) initiative are routinely screened for TB and the PEPFAR program has supported extensive training for health care workers in the active detection of TB; automatic reports are generated every time patients present with TB symptoms and skin tests have also been largely available by the program to help with TB screening. A recent evaluation indicated that HIV testing of TB patients in PEPFAR sites increased from 76% (2010) to just over 90% (2012).

Case finding has been expanded through active screening in HIV clinics, prisons, urban settings, and health care settings and among people whose family members have TB and these efforts appear to be paying off.

There have also been tremendous advances in the ability to diagnose TB. Standard tools, like microscopic evaluation of sputum samples, have been improved. The National Laboratory in Haiti now has the ability to do TB cultures—this is especially important for the ability to detect TB that is resistant to standard TB treatment drugs. An important new test called Gene Xpert has been introduced. Eight facilities are already offering this test, which can confirm a diagnosis of TB in only a few hours, and can also check for resistance to TB treatment drugs.

There have been changes in the treatment of TB as well. At the moment, only a few sites can provide good treatment for patients with drug-resistant TB, but the capacity to provide treatment for TB is also being expanded. There are also efforts to prevent TB, which include activities to reduce the risk of transmission of TB in health facilities, and efforts to provide early treatment to people with HIV, which helps keep their immune systems strong and reduces the risk of TB.

These efforts are important in the global fight against TB. Haiti has the highest reported TB prevalence rates in the western hemisphere (300 cases per 100,000 people).

The TB program continues to face serious challenges however, the progress is real, and with continued efforts, the burden related to tuberculosis will be lessened.

HL/ HaitiLibre