Hope Restored in the Kingdom of Eswatini as Tuberculosis Incidence Reduced by More Than Half

Content provided by APO Group. CNBC Africa provides content from APO Group as a service to its readers, but does not edit the articles it publishes. CNBC Africa is not responsible for the content provided by APO Group.

Twana Bhembe witnessed the devastating effects of tuberculosis (TB) when her sister died from the disease in 2011. That was before she and her husband were each diagnosed with the disease, a year apart.

TB has been a frequent visitor not just in Bhembe’s family but across the Kingdom of Eswatini. But those visits are a thing of the past now.

Once labelled the country with the world’s highest TB incidence, the Kingdom has turned the tide and reduced the scourge by more than half. An alarming rise in TB cases was noted in the early 2000s, threatening the country’s entire population of slightly more than one million people: the mortality rate was among the highest in the world, at 18 per 100 000 people in 2003.

At that time, HIV and AIDS were considerable public health threats and drug-resistant strains of TB had developed, all of which exacerbated the TB epidemic. “Close to 12 000 cases of TB were being reported annually, with a very high death rate, poor case finding and poor treatment outcomes,” says Themba Dlamini, the National TB Programme Manager.

“Transmission was also high, leading to an unacceptable incidence of 1250 TB cases per 100 000 people.”

An all-fronts assault

In 2011, the Government of Eswatini declared TB a national emergency, paving way for an accelerated emergency response that included creating awareness about the disease, prevention, quick diagnosis, effective treatment, patient support and follow-up. Health personnel were intensely trained to better manage TB patients. 

The response roped in an array of partners, including the KNCV Tuberculosis Foundation, the Global Fund to Fight AIDS, Tuberculosis and Malaria, Médecins Sans Frontières and the Columbia University (USA) Mailman School of Public Health, with guidance from the World Health Organization (WHO). The country received US$40 million from the Global Fund to fund the emergency response, running alongside the Government’s general strategic plan.

“The emergency plan had intervention points that we knew we needed to hammer hard for things to change,” says Dlamini. Interventions included robust awareness, the introduction of rapid diagnosis for drug-susceptible and drug-resistant TB, which reduced the waiting period for results.

The introduction of new diagnostic tests also allowed for drug-resistant TB tests to be done in country instead of being sent to South Africa, which had been the previous practice.

Diagnostic sites increased, from 13 to 48, as did the TB management units, to 180 of the 204 clinics in the country. There was also involvement of the private sector where TB clinics and laboratories were set up in the major private clinics, which then received drugs and technical support from Government and were included in quarterly review meetings.

Before the TB management units were set up, the treatment drop-out rate had been high, at 15%, because drugs were available in only 13 sites, which compelled people to travel long distances to the nearest location. With the Global Fund assistance, the Ministry of Health was able to hire more people to do intensified case finding – screening everyone seeking health services at a facility.

“Awareness was poor. People would feel better after two months and stop taking the drugs,” recalls Dlamini. “Hence, we deployed 30 adherence officers on motorbikes checking people who missed their appointments and sometimes bringing pills for those who were very sick and could not go to the clinic. Drug-resistant TB patients were given money to go to the hospital and to buy food. We also hired treatment supporters to help them manage side effects because people used to drop out due to side effects.”

The TB programme deployed 369 active case finders who relied on bicycles to trace contacts in communities. People who tested positive for TB were also tested for HIV. To date, 100% of TB patients know their HIV status and 100% of those found to be positive are on HIV treatment.

Hope returns

“We started seeing people coming in early to start treatment, unlike before, when people would deteriorate to a level where it was not easy to treat them,” says Dlamini. “We implemented all these interventions following the WHO guidelines, technical support and capacity building for the programme.”

After all the interventions, hope replaced the scourge in the Kingdom. Incidence was reduced to around 300 cases per 100 000 population in 2017, from the 1250 it had been in 2009. Because of her sister’s death in 2011, Bhembe, now 39, knew the disease too well. But then her husband was diagnosed with TB in 2015. A year later, she too, tested positive with both TB and HIV.

“I got so afraid because I knew the symptoms,” she says. “I had seen my husband suffering from TB and my sister dying of the disease. Because I knew the symptoms, I quickly accepted the situation and requested the doctor who diagnosed me to start me on treatment immediately because I didn’t want to die like my sister.”

Some three months after starting treatment, Bhembe began vomiting each time she took the tablets. This led to her developing drug-resistant TB. Her doctors switched her to the injectable treatment for the drug-resistant strain.

“I spent a month admitted at the drug-resistant TB hospital in Moneni. Later, the doctors discovered that I was losing my hearing. Despite all these challenges, I knew I was going to be okay, and I was determined to adhere to the treatment schedule as advised by the doctors,” says the mother of two children, grateful to the Government to be alive. Her husband also beat the diseases and they are both free of TB.

“I thank the Government for providing the treatment free of charge because, if it was paid, I would not have afforded it. And I would have died. Now I am feeling fine and happy,” she says.

Distributed by APO Group on behalf of WHO Regional Office for Africa.Media filesDownload logo

Related Content

Health care group RH Bophelo lists on the Rwanda Stock Exchange

South African multi-million health care company, RH Bophelo today cross-listed on the Rwanda Stock Exchange, making it the 9th company to be listed on the RSE stock market. This comes at a time when another South African company, Cimerwa PPC is also planning the same move. Celestin Rwabukumba, CEO, Rwanda Stock Exchange joins CNBC Africa for more.

The role of financial players in Rwanda’s post COVID-19 recovery

Financial institutions are expected to be central in the bounce-back of small and medium enterprises post-COVID-19. But how much of a role will it be? CNBC Africa's Arnold Kwizera spoke to Jane Mwangi, Managing Director, KCB Foundation for more.

Grading Buhari’s economic performance over the past 5 years

May 29th marked five years since President Muhammadu Buhari took over leadership in Nigeria. One year into his second tenure as president, Vincent Nwani, a Business and Investment Consultant joins CNBC Africa for an economic scorecard of Buhari’s lead administration.

Arunma Oteh on Adesina’s probe & why COVID-19 represents an opportunity for Africa

Some former African presidents have shown their support for the president of the African Development Bank, Akinwunmi Adesina. This was in a letter over the 16 count allegations levelled against him to which Adesina had stated his innocence. Although the ethics committee of the board of directors of the continental bank has cleared Adesina of these charges, the United States which is one of the major shareholders of the bank has called for an independent probe into the allegations.

Subscribe to our newsletter

Sign up for free newsletters and get more CNBC AFRICA delivered to your inbox

More from CNBC Africa

Capital Appreciation’s Bradley Sacks on COVID-19 impact on business

Capital Appreciation, a JSE fintech player raised its final dividend by over 17 per cent following an increase in annual revenue and profits. The payment solutions provider saw increased demand for its digital and cloud based services and said the Covid-19 pandemic has not impacted earnings negatively. Bradley Sacks, Joint CEO at Capital Appreciation joins CNBC Africa for more.

COVID-19 lock-down: This is how much SA’s alcohol ban cost the economy

After a two month ban on liquor sales, stores reopened today and thirsty consumers were waiting in line to replenish their stock. While the industry expects liquor sales to spike in the coming days, the ban on sales during the Covid-19 lock-downs has cost over 117,000 jobs. That’s according to the South African Liquor Brand owners Association (SALBA). SALBA CEO, Kurt Moore joins CNBC Africa for more.

Absa May manufacturing index surprises

The rand is rallying. Eight million people are back at work. Petrol will cost one rand and eighteen cents per litre more from next month and the latest Absa Purchasing Managers Index business activity sub-index rebounded to 43.2 in May after collapsing to an all-time low of 5.1 in April. The magnitude of the increase is surprising, given that most parts of the manufacturing sector could only operate at 30 per cent of employment capacity in May due to lockdown. Miyelani Maluleke, Economist at Absa Corporate and Investment Banking joins CNBC Africa for more.

COVID-19: Are Rwanda’s taxi motorbikes equipped for return?

Last night the Rwandan Prime Minister's office announced that the previously slated date of reopening of passenger motorbikes - which was meant to be today - has been extended until further notice. As the country gears up to reallow taxi-motorbikes to start operating again after over 2 months of being out of service due to Covid-19 measures; tech and mobility company, Pascal Technology has been hard at work equipping them to meet new regulatory measures. CNBC Africa spoke to Pascal Ndizeye, CEO and Founder, Pascal Technology to gauge their progress.

Partner Content

Sanlam Emerging Markets and its partners on the African continent invest over $12 million to fight COVID-19

As we go through this global pandemic together, it is the little things we miss. A high five, a handshake, a walk...

VIVO CEO is a dynamic leader for this innovative global brand

May 2020 -- Six months ago the vision for vivo in South Africa was just beginning to...

Trending Now

Why Germany’s coronavirus death rate is so low | CNBC Explains

While Germany has one of the highest numbers of coronavirus cases in Europe, its death rate is significantly lower than its neighbors. CNBC’s Timothyna Duncan explores the strategies the country has employed to manage the spread of the disease. ----- Subscribe to us on YouTube: http://cnb.cx/2wuoARM Subscribe to CNBC International TV on YouTube: https://cnb.cx/2NGytpz Like our Facebook page: https://www.facebook.com/cnbcinternational Follow us on Instagram: https://www.instagram.com/cnbcinternational/ Follow us on Twitter: https://twitter.com/CNBCi...

“Stop this culture of frivolous allegations” former World Bank Treasurer Arunma Oteh defends African Development Bank President

"So my appeal really is that we dispense of this issue. That we stop this culture of frivolous allegations around the times of elections. And allow the African Development Bank to support the African continent at this important time.”

How LGBTQ+ Pride Went From Movement To Marketing

With all of the changes to this year’s Pride lineup, many are left wondering how these virtual events will maintain their support of small LGBTQ+ owned businesses, like restaurants, bars, and brick-and-mortar stores, as well as LGBTQ+ focused nonpr

CNBC Africa celebrates 13 years on air

Today, June 1st marks our 13th Anniversary at CNBC Africa. As we celebrate our work and experiences at a time when the world is subdued by the coronavirus, here are views of some of our top analysts and friends from over the years....
- Advertisement -