PIVOT and Ministry Gear Up to Fight Tuberculosis
Dr. Michael Rich, PIVOT co-founder and world-renowned tuberculosis expert, recently helped PIVOT reach a major milestone: launching integrated support for the Madagascar National Tuberculosis Program in the Ifanadiana District.
During a visit to PIVOT in early January, Dr. Rich joined a group of PIVOT and Ministry of Health doctors to review both the TB detection and death rates in Ifanadiana District. Based on Madagascar national data, the detection rate was deemed to be approximately 50% of the estimated rate of disease, while the death rate was several times higher than normal for national programs. Armed with this data and in consultation with the Ministry of Health, Dr. Rich and PIVOT Country Director Dr. Ali Ouenzar decided to launch a coordinated program of PIVOT support to strengthen the identification, diagnosis, and treatment of tuberculosis.
The week-long first round of government-sponsored training was comprised of in-depth lectures and discussions with PIVOT staff from health centers and the District Hospital. Topics included the demographics, natural history, the medical signs and symptoms of TB, the techniques for collecting and preparing sputum samples for diagnostic evaluation, and the specific medications, dosages, and schedule required for the treatment of TB following diagnosis.
A second round of training was provided to the Community Health Workers (CHWs) who work in the farthest reaches of the district, where initial screening is especially crucial to preventing the spread of the disease. This course consisted of the basics on how to screen for TB and examine patients with histories or physical exams presenting symptoms of the disease (e.g., chronic cough, night sweats, weight loss, or contact with a known TB patient). CHWs learned protocol for how to safely refer potential cases of TB to higher levels of care for physical exams and diagnostic testing.
Tuberculosis remains a prevalent health issue in Madagascar due to lack of training and resources necessary to perform screening and diagnosis, high cost of medications, and the dearth of infrastructure required to cure the disease. PIVOT’s goal is to continue to partner with the Ministry of Health to train personnel and improve infrastructure in order to safely diagnose, hospitalize, treat, monitor, and cure TB patients in Ifanadiana District.