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Tuberculosis, commonly known as TB, is a bacterial infection that can spread through the lymph nodes and bloodstream to any organ in the body. It is most often found in the lungs. Most people who are exposed to TB never develop symptoms because the bacteria can live in an inactive form in the body.

The disease is transmitted from a sick patient to another through coughing, singing and sneezing and its major symptoms are coughs, which last for more than two weeks, loss of weight, tiredness, night sweats, chest pain and cough with bloodstained sputum.

This year, the world celebrated World TB Day on March 24, on the theme: “Treat, Cure Everyone: The Changing Phase of Ghana’s TB Epidemic.”

TB in Ghana
Preliminary results from a 2013 prevalence survey suggested that the TB burden in the country was higher than previously thought.

The survey, commissioned by USAID, showed that TB cases were three times higher than the known national figures.

A 1997 estimated TB burden by the World Health Organisation (WHO) showed a TB prevalence of 260 per every 100,000 persons and a TB incidence of 165 per 100,000 persons.

The prevalence of a disease refers to the actual number of cases alive in a given period whereas the incidence describes new cases occurring within a period.

In 2013, WHO then estimated a drop in the cases of TB in Ghana at 72 per every 100,000 persons.

However, the 2013 survey showed that TB prevalence in the country was 286 per every 100,000 persons.

The prevalence survey also identified a large number of TB cases among pregnant women.

Dr Frank Bonsu of the National TB Control Programme at a stakeholders meeting in Accra recently said most of the cases found during the survey were not on treatment.

Many of those who had sought care did so through the local pharmacy, self-medication or through traditional medicine.

According to Dr Bonsu, the high prevalence of TB, coupled with the synergistic relationship with HIV and AIDS, doubles the burden on the population suffering from the disease.

The TB mortality rate in Ghana is considered high at 7.5 per every 1,000 infected and the prevalence is 264 per 100,000 in general population.

He said the mode of testing for TB, which was basically through chest X-ray over the years, was only able to detect 40 per cent of cases.

Health sector plan
With a more enhanced mode of testing such as the use of the GeneXpert and the Digital CXR, which are all modern technologies, Dr Bonsu, in giving an overview of a Health Sector Strategic Plan, said the first goal was to reduce by 20 per cent the 2013 TB prevalence baseline level of 286 per 100,000 persons by 2020 in line with post-2015 Global TB Control Strategy.

The second goal, he said, was to reduce by 35 per cent the 2012 TB mortality rate baseline of four deaths per 100,000 persons by 2020.

The third goal was to end the TB epidemic in Ghana by 2035 without catastrophic cost due to TB-affected families.

Enhancing care
To ensure that cases were detected early and treated promptly, 90 districts have been selected for an early intervention system.

The districts, which include four high HIV and AIDS-prone districts, would receive improved hospital-based TB case detection services through the use of modern testing equipment such as X-ray machines.

Improving TB case detection among persons living with HIV (PLHIV), as well as improving case detection among other high risk groups such as prisoners, children, diabetic patients, as well as active screening among miners, urban slum dwellers and the older age groups, using mobile equipment, forms part of the goal of the National TB Control Programme to reduce the 2013 TB prevalence baseline level by 20 per cent, and finally stop the spread of TB epidemic by 2035.