Lomé – In January 2024, Yao*, a 67-year-old farmer living in Agou, about 100 kilometres north-west of Lomé, experienced unusual discomfort that led him to seek medical attention. These included chest pains and unexplained intense fatigue that lasted for a fortnight. Following tests, he was diagnosed with tuberculosis (TB). “I was surprised and very sad to find out that I had the disease. I had suffered too much and I wanted to be cured by any means necessary,” he recalls. 

In Togo, 30 out of every 100 000 people contracted the disease in 2023, according to the World Health Organization (WHO) 2024 global report on TB. The country has implemented several initiatives to improve the fight against TB, as Professor Abdou Gafarou Gbadamassi, Coordinator of Togo’s National Tuberculosis Control Programme (PNLT), explains: “Several combined interventions are enabling us to make progress in the fight against this disease, focusing in particular on case-finding, early detection, and the effective treatment of patients.”

At the heart of early detection is the optimization of GeneXpert machines which enable sputum samples from patients to be rapidly tested to confirm the disease. This approach, recommended by WHO as a first-line diagnostic tool, has made a significant contribution to strengthening case detection in Togo. Until 2020, the country had only 15 GeneXpert machines across 14 sites, but this has increased to 52 sites over the past four years.

Professor Gbadamassi is delighted with this development, which he says has boosted the country’s progress: “Thanks to this notable improvement in GeneXpert capacity, early case detection has been reduced from 72 to 24 hours nationwide. This is helping to move our country towards the eradication of tuberculosis. 

“Other key areas in the fight against tuberculosis include community involvement to ensure patient-centred treatment, free treatment for all forms of tuberculosis, and nutritional support for the most vulnerable patients.”

Thanks to the availability of a machine at the Prefectural Hospital Centre (CHP) of Agou, where Yao sought help, he was able to start treatment quickly. After the first few weeks, which he found difficult due to the high treatment dosages, he felt his condition improve. “The medication made me very weak at first. After the first two months, I had an initial check-up and the results were negative. I had further checks in the fifth and sixth months, after which I was declared cured of tuberculosis. I suffered so much at first that I was convinced the disease would kill me!” 

In June 2022, a “FAST” strategy focused on active research at four sites in the Agoè Nyivé and Golfe districts of Lomé, enabled the detection of nearly 10 000 TB cases in the period to 2024 (3041 cases in 2022, 3065 cases in 2023, and 3129 in 2024). These figures were a significant improvement on the 2312 and 2418 cased detected in 2020 and 2021 respectively. 

From 2020 to the end of 2023, an investigative project contributing to the elimination of TB in Africa also studied contagious patients in 35 diagnostic and treatment centres (CDTs). This allowed for early detection of TB patients and the provision of preventive chemotherapy treatment to the uninfected, including children under 15 and people living with HIV. Since 2024, this intervention has been extended to the other 55 CDTs, with the support of the Global Fund.

Yorouma Djobo, CDT focal point at the Agou CHP, has seven years’ experience as a health worker caring for TB patients, also providing them with essential advice. He is responsible for screening, initiating treatment, and treatment monitoring of TB patients in the Agou health district. Djobo sees an average of three TB patients every month, and emphasizes the role of the family in supporting them. “Our role is to ensure that everyone who is screened receives the necessary treatment and recovers their health. Once the family has understood the harmful effects of the disease, they become our main support and take charge of the patient’s treatment, adopting the advice given to patients in order to help them.”

In 2022, Djobo was among 95 focal points trained in all aspects of TB, including paediatric TB, therapeutic patient education, management guidelines and preventive treatment. That same year, 60 laboratory technicians were trained on GeneXpert stool diagnosis, and in 2024, 65 laboratory technicians were trained in bacilloscopy diagnosis of tuberculosis.

WHO’s support includes the provision of experts, technical support for the development and validation of documents and guidelines, and financial assistance for key events or activities. At the end of 2023, the Organization also initiated the so-called BBNT approach (initials for Benin, Burkina Faso, Niger and Togo) as a framework for exchanging experiences in the fight against HIV, viral hepatitis, TB and malaria, supporting field visits to share best practices in these countries.

For Dr Laconi Kaaga, head of the TB Control Programme at the WHO country office in Togo, the main aim of WHO’s support is to ensure that “every at-risk person has access to rapid and effective prevention, diagnosis and treatment of tuberculosis”.

Having regained his health and resumed his work as a farmer, Yao encourages everyone to seek medical attention if they suffer from a persistent cough, and to follow the advice of the medical staff until they are completely cured. He also has a special message for patients’ families: “My family has been essential to my recovery. Without their support, I would have died of TB! If a member of your family has this disease, stay close to them, help them to stay motivated, and never give up hope.”