The story of a village in Western Kenya.
As African health ministers meet and pledge their commitment to fight TB in the continent, it is important to appreciate the complexity and challenges that must be overcome for tangible results to be obtained. TB is an airborne infection which is easier to contract than HIV/AIDS, especially where there is crowding and housing/ ventillation is poor. TB was largely under control in most of the continent until the HIV/AIDS epidemic. It is therefore prudent to integrate the control programs for the two diseases in order to conserve resources and and make better use of limited skilled staff. That is what we are trying to do in Sagam.TB is a major health problem in Siaya District, and has resurged with the HIV/AIDS epidemic. Sagam Community Hospital has all the neccessary diagnostic capability - clinical, laboratory and radiological. The hospital is also part of the nationwide TB treatment network that allows it to obtain anti-TB drugs from Siaya District Hosital and give it free to all patients with confirmed diagnosis. Improving access to diagnosis and treatment, both economic and geographical,is an important factor in this war. The hospital submits monthly record to the District TB coordinator who also makes regular visits to the facility. In addition to the clinical services, the hospital conducts community awareness campaigns through its extensive outreach program. Patients too weak to travel to the hospital are either admited or served their medications through the home based care program. Strong public-private partnership, with committed community participation will serve Africa well in the war against these epidemics. Governments must therefore enact appropriate policies to facilitate greater participation of the private sector and flow of resources to the communities. This, unfortunately, is not the case in most countries.
This still does not answer the question about Sagam. During the period when TB cases increased fivefold in Kenya, what happened in Sagam? And are data kept separately on TB cases related to HIV infection/AIDS and TB cases with no apparent connection to HIV/AIDS? Is that an important measure given that HIV/AIDS patients can spread TB? In any case, what do the data tell us about trends in Sagam in comparison with the country as a whole on the TB quesiton?
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