Brazzaville – Access to tuberculosis (TB) diagnosis as a crucial first step to detect and treat the disease remains a huge challenge in Congo, where around half of the estimated 21 000 TB cases are detected every year. To support the country scale up testing, World Health Organization (WHO), with financing from the Global Fund, has provided GeneXpert diagnostic machines in the capital Brazzaville and Pointe-Noire, the country’s second city. The machines have improved the rate of testing eight-fold, allowing for timely enrolment of TB patients on treatment.
WHO/OLUSIMI Vijay
The Antituberculosis Centre in Brazzaville is usually packed, receiving up to 30 patients daily. Equipped with modern diagnostic machines, the centre is improving access to testing services and care for all. Despite being the cornerstone in the fight against TB, testing if often a challenge. At the centre, samples are collected, analysed and medicines provided to patients.
WHO/Simi Vijay
The GeneXpert diagnostic machines were delivered and set up in December 2021 and have considerably boosted diagnosis, with direct impact on treatment.
“In the past, the centres used to be swamped with samples to be analysed – a never-ending backlog,” says Dr Franck Okemba Okombi, Director of the National Tuberculosis Programme. “The (centre) in Brazzaville used to receive an average of 40 to 50 new patients daily, but the machines they had could diagnose only 24 patients per day at most. We were able to treat only the most critical cases.”
“In the past, the centres used to be swamped with samples to be analysed – a never-ending backlog,” says Dr Franck Okemba Okombi, Director of the National Tuberculosis Programme. “The (centre) in Brazzaville used to receive an average of 40 to 50 new patients daily, but the machines they had could diagnose only 24 patients per day at most. We were able to treat only the most critical cases.”
WHO/OLUSIMI Vijay
The GeneXpert machines in Brazzaville analyses around 70 samples every day. In Pointe-Noire, at least 60 samples are analysed daily. The proportion of the population with access to diagnostic services has soared, from 30% to 9% per cent.
“The fight against tuberculosis requires a good system for screening patients. WHO works and advocates for patient-centred services, which include routine screening of contacts and high-risk groups as well as preventive treatment for these people,” says Dr Lucien Manga, WHO Representative in Congo.
WHO is also supporting capacity-building among service providers at new diagnostic and treatment centres to include TB in the package of essential health services. This will contribute to the decentralization of services and thereby boost screening.
“The fight against tuberculosis requires a good system for screening patients. WHO works and advocates for patient-centred services, which include routine screening of contacts and high-risk groups as well as preventive treatment for these people,” says Dr Lucien Manga, WHO Representative in Congo.
WHO is also supporting capacity-building among service providers at new diagnostic and treatment centres to include TB in the package of essential health services. This will contribute to the decentralization of services and thereby boost screening.
WHO/Simi Vijay
Raide Missamou, 27, was diagnosed with tuberculosis in September 2021 at the Brazzaville TB centre.
“At first,” she recalls, “I was feeling aches and sharp pains. Then one day, I collapsed on the way home from work. This sent me into deep disarray: as an only child, the last thing I wanted was to fall ill and not be able to help my parents.”
For two months which she describes as “the worst period of my life,” Missamou’s family tried all manner of treatments without success.
“There were visits to doctors who prescribed medication that didn’t relieve my pain, then prayer sessions to ‘break the spell’, then various herbal concoctions to drink that were supposed to cure me. None of it changed a thing.”
Seeing her condition worsen, Raide eventually found her way to the TB centre where she tested positive for tuberculosis.
“At first,” she recalls, “I was feeling aches and sharp pains. Then one day, I collapsed on the way home from work. This sent me into deep disarray: as an only child, the last thing I wanted was to fall ill and not be able to help my parents.”
For two months which she describes as “the worst period of my life,” Missamou’s family tried all manner of treatments without success.
“There were visits to doctors who prescribed medication that didn’t relieve my pain, then prayer sessions to ‘break the spell’, then various herbal concoctions to drink that were supposed to cure me. None of it changed a thing.”
Seeing her condition worsen, Raide eventually found her way to the TB centre where she tested positive for tuberculosis.
WHO/OLUSIMI Vijay
Once diagnosed, Missamou was able to receive free treatment. Juliette Ngampana, Principal Secretary of Socio-Sanitary Administration at the TB Centre, made sure she received a combination of antibiotics and chemotherapy.
“When someone’s been diagnosed with tuberculosis, it’s essential to respect the frequency and dosage of treatment, and to maintain proper hygiene so as not to infect those around you,” says Ngampana. “As long as you are sick, certain practices are to be avoided at all costs: alcohol and tobacco consumption, hugs, etc.”
“When someone’s been diagnosed with tuberculosis, it’s essential to respect the frequency and dosage of treatment, and to maintain proper hygiene so as not to infect those around you,” says Ngampana. “As long as you are sick, certain practices are to be avoided at all costs: alcohol and tobacco consumption, hugs, etc.”
WHO/OLUSIMI Vijay
Dr Michel Illoye-Ayet, who has been running the TB centre for five years, has seen more than 600 TB cases, the majority of them cured.
“Most patients are aware of the gravity of the disease, so they take the treatment really seriously throughout the required six months,” he says.
Unfortunately, not everyone goes the full distance.
“Some patients, feeling an improvement in their clinical state after a month or two, choose to abandon treatment,” he laments. “Incomplete or poorly followed treatment makes the bacteria resistant and leads to complications that minimize the chances of recovery, placing the patient’s life in danger.
“At that point, first-line treatment no longer works.”
“Most patients are aware of the gravity of the disease, so they take the treatment really seriously throughout the required six months,” he says.
Unfortunately, not everyone goes the full distance.
“Some patients, feeling an improvement in their clinical state after a month or two, choose to abandon treatment,” he laments. “Incomplete or poorly followed treatment makes the bacteria resistant and leads to complications that minimize the chances of recovery, placing the patient’s life in danger.
“At that point, first-line treatment no longer works.”
WHO/OLUSIMI Vijay
For her part, Missamou scrupulously followed the instructions she received – and the results of her last control X-ray prove that she is cured.
Her health restored, she has been able to resume life as normal, and spends her days in search of a job. As far as she is concerned, her most treasured gift is already in her possession.
“After what I went through with this illness, I am now convinced of one thing: without health, very little in life has meaning.”
Her health restored, she has been able to resume life as normal, and spends her days in search of a job. As far as she is concerned, her most treasured gift is already in her possession.
“After what I went through with this illness, I am now convinced of one thing: without health, very little in life has meaning.”
For Additional Information or to Request Interviews, Please contact:
Mariam Ouedraogo
Chargée de communication
OMS Congo
Email: mouedraogo [at] who.int (mouedraogo[at]who[dot]int)
Kadijah Diallo
Communications Officer
WHO Regional Office for Africa
Email: dialloka [at] who.int (dialloka[at]who[dot]int)