DAPP fighting TB, HIV and AIDS through an integrated approach in Thyolo
DAPP Malawi has since February 2015 been implementing the Integrated HIV/TB Project in Thyolo district which is funded by Comic Relief through TB Alert. The project aligns with the World Health Organisation’s ENGAGE-TB approach to integrate community-based TB and HIV/TB prevention, care and control activities.
The activities being carried out by DAPP are based on a new paradigm for integrating HIV and TB at the grassroots through a combination of activities that tackle stigma and discrimination, strengthen clinical services, build family and community capacity to support the patients and improve the nutrition status of HIV and TB affected families.
DAPP is scaling up TB – HIV interventions in Thyolo using the systematic door to door approach, the project raises awareness of TB and HIV; identifies HIV+ and TB affected people; establishes sputum collection points and; links patients to treatment thus reducing deaths, containing onward infection through TB contact tracing and the development of drug resistance.
During a recent field visit organised by the project recently, Group Village Headman Bvumbwe observed that occurrence of death due to TB and HIV related causes has been reduced in his area because patients are now seeking for early treatment following referral by Community Health Workers and close follow up visits by CHWs and volunteers who together ensure that patients adhere to treatment.
“I want to thank DAPP for the Door to Door TB, HIV and AIDS Campaign that has helped to reduce the number of deaths as a result of TB in my area. This approach has saved many lives especially in my area because people are encouraged to go for screening and to seek treatment early through this project.
“The nutritional status among patients on treatment has improved and every month the patients are getting nutrition support like maize, soya beans and Sibusiso food supplements among other interventions.“. I call for the continuation of the project. Lives have been improved and saved from early deaths,” said Bvumbwe.
Several community members who are under the project expressed profound gratitude with the coming of the TB/HIV project in their area most citing that if it were not for the project they would not have known their TB and HIV status. The community members also shared how they had been empowered to make decisions about their lives and live according to their status inorder to prevent HIV infection and re-infection.
A young mother who was diagnosed with TB four months ago recalled how her health status improved after a Community Health Worker referred her to the health centre following weeks of being encouraged to go for testing; she said the nutrition support she started receiving though the project and the medication from the health centre have greatly improved her health and nutrition status.
Concurring with the community members, Bvumbwe Community Care Organisation (BVUCCO) Coordinator, Agness Namaona added that through the sensitization campaigns and door to door visits, people were now free to go for TB screening, HIV testing and counselling services that there is reduced stigma and discrimination in the communities.
Makungwa Health Centre Senior Medical Assistant Thom Kapinza Soko hailed DAPP for working closely with government to reduce TB, HIV and AIDS related deaths through the TB/HIV project. The DAPP project has established a strong link between the people and the existing health services which. This has further created an increased demand on the health centre to cope with the increasing number of people who seek treatment and this saves more lives. Through the trios which are formed comprising of the patient and two relatives, drug adherence has been enhanced unlike in the past were the patients mostly had the sole role to ensure they took their medication correctly.
“As a hospital we want to thank the DAPP Community Health Workers and Volunteers who are helping us identify presumed cases in the villages and refer them to the hospitals. We also want to recommend the nutrition classes and cooking demonstrations conducted in the communities’ in order to teach people about the importance of healthy food. The patients and their families are able to prepare a variety of healthy meals using food items from the six food groups. This has further enabled the patients to boost their nutrition and assisted in drug adherence as some patients used to report that they have increased appetite when taking the TB medication and that it became difficult to take the medication especially when they had no food,” said Soko.
DAPP Head of Programs, Moses Chibwana said through the project, DAPP is contributing towards the government’s efforts in raising awareness on TB, TB/HIV co-infection, early case finding and linking patients to effective treatment and ensuring that patients adhere to TB HIV treatment. He acknowledged the role that the DAPP Community Health Workers, community volunteers, traditional leaders, support groups and health personnel play towards the achievement of the project goals and alluded the success of the project largely due to this collaboration.
“Since inception, we have reached 123 735 people with HIV and TB information through the door to door approach and 11 484 presumptive cases have been screened for TB at their door step. The project also provides nutrition support for Multi-Drug-Resistant tuberculosis (MDR-TB) patients and TB/HIV co-infected patients,” said Chibwana.
Chibwana added that although the project is on course and meeting its intended goals, there are some mobility challenges being faced by the team of committed volunteers who work tirelessly together with the DAPP Community Health Workers to ensure that their communities receive TB/HIV information and access health services at the health centre as they walk long distances to reach the communities.