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"How long have you been coughing?" It is a simple question "a priori" that can arise in any hospital. But becomes essential in Uganda, with 90,000 TB patients a year, the most lethal infectious disease in the world.
Hajara Nagudi, a young mother, is waiting in front of the Nsagi health center clinic, where she is a few kilometers from the Ugandan capital, Kampala.
Despite the light but steady rain, she decided to go to this clinic because her baby one year old and four months old is coughing. "She is sick, she is coughing," she says
Nagudi a HIV, the AIDS virus, a disease highly related to tuberculosis that increases the chances of contracting it.
Every patient who comes to the center, whether it's diarrhea or a simple herpes, doctors and nurses ask the same questions: have you coughed for more than two weeks? Have you been in contact with other patients? Do you notice that his pants are falling lately?
These are easy questions, a simple clinical evaluation, but if they are done thoroughly, they can help detect cases of tuberculosis, cough syrups
In this way, doctors estimate 4,000 to 6,000 people a month.
If the answer is affirmative in some cases, the nurses ask the patient to do a sputum test, saliva, which in one hour can indicate if she has tuberculosis.
With these "active detection tools", set up in this center thanks to the program of the International Union Against Tuberculosis and Lung Disease (The Union), in Uganda 6% of cases of the disease are detected.
In fact, according to the Ugandan government's National Tuberculosis and Leprosy Program (NTLP) director, Mugabe Frank Rwabinumi, since This type of method is the first time that '' they notice an increase in cases.
And this is not because there are more, but because they can now detect them.
Abdul Samwaddu, a 29-year-old man, had the typical symptoms: coughing, night sweats, breathing was difficult … At the pharmacy he was given cough remedies, which was not a problem. did not help to improve, and in clinics he even had up to 15 injections of fever, which did not fall [19659003Only they detected the disease when they arrived at the public center of Nsagi according to the usual protocol : questions, sputum test and HIV
And Samwaddu went home with the pills, because tuberculosis despite its lethality, it can be cured with treatment six months.
This young man is dedicated to collecting money from passengers of minibuses that serve as public transport in Kampala, and continued to work despite the fact that the disease is spreading in the air and , especially, in the They are small and closed.
Father Galwago's father, a four-year-old boy, also had to be infected, in the minibus (popularly known as "matatu") that he was driving, then he stuck it to l & # 39; child. Both, fortunately, are well and recovering.
In addition to the questions, a key factor in the fight against tuberculosis in this center are the volunteers who go to the communities and help to continue the treatment because if a TB patient leaves the pills before end of six months, the disease can develop resistance, and then it is more difficult to treat.
"If a health center worker finds that a patient does not come to pick up his medication, first they call them on the phone, when the calls do not work, the worker goes into the community to see what's going on, "says The Union's director in Uganda, John Paul Dongo, in Efe
. The problem, sometimes, is stigma. Tuberculosis is often (but not necessarily) associated with HIV, and it bears all the prejudices that AIDS brings .
"Stigma is usually present because the appearance of a TB patient is" the same thing as an HIV-infected person, "says Josephine Nakakande, pediatric specialist at Nsagi. [19659003] Even health workers themselves are sometimes afraid of the disease
"When I arrived, I saw that Workers did not want to deal with TB cases, we have this negative attitude that if I take care of a case of tuberculosis I will have it, which is wrong, "says Nurse Harriet Nabunya
. According to official data and estimates, there are about 90,000 TB cases each year, but it is estimated that the system does not record about 40,000 cases, making the methods as simple as the demand become essential.
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