“Makasi” is a seven-year-old orphan from Losikito village in Arusha, Tanzania. Makasi is HIV positive and, although he takes his antiretroviral medication as prescribed, last year Masaki became very ill. Noticing his deteriorating health, Masaki’s grandmother took him to see a pastor, who treated Makasi with herbal medicine. When he returned home from his appointment with the pastor, Makasi stopped taking antiretrovirals, as he believed that God had healed him. A few days later, however, he again became very ill. This time, Makasi’s grandmother sent him to Otrumet Health Centre for treatment.
Makasi’s first examination at the health center showed that he was severely emaciated and, for six months, had consistently weighed just 10 kg (22 lbs). The heath center staff also noted that Makasi had shortness of breath, a fever, a cough, and diarrhea. Using a pediatric tuberculosis (TB) score chart and standard operating procedures developed by the USAID-funded Tuberculosis Indefinite Quantity Contract (TB-IQC), the clinicians were able to quickly determine that Makasi was suffering from TB. His doctors initiated TB treatment on August 29, 2011. Makasi completed six months of TB treatment and is now a playful child weighing a healthy 21 kg (46 lbs).
Management Sciences for Health (MSH), in collaboration with the Program for Appropriate Technology in Health (PATH), the Tanzanian Ministry of Health and Social Welfare, and the National TB and Leprosy Program, implements the TB-IQC project in Tanzania.
From April to September of 2011, these partners pilot tested new standard operating procedures for pediatric TB and job aids at 12 health facilities in Arusha and Meru Districts. These innovative materials helped health care professionals to diagnose Makasi with TB during his stay at the Otrumet Health Centre.
Prior to implementing these tools, children with TB, particularly those with malnutrition, were not easily or accurately diagnosed by health care providers at Otrumet Health Centre. In 2010, for example, providers at Otrumet diagnosed and treated 20 children for TB. In 2011, with the introduction of job aids and standard operating procedures, providers diagnosed 53 children with TB, who otherwise may not have been recognized. The number of detected TB cases has increased by 81 percent in the 12 facilities in Arusha and Meru piloting the TB-IQC tools and strategies.
Masaki is just one of the many children who have and will benefit from TB IQC’s critical health interventions in Tanzania.
Dr Irnei Myemba is TB advisor and MSH TB-IQC country coordinator.