GIOPINI: Taming Tuberculosis at Grassroots

With over 600,000 tuberculosis positive persons, Nigeria is the country with the third highest number of patients of the scourge in the world and until the introduction of the Active Case Finding, ACF; recently, hundreds of thousands of patients of the disease have remained unknown

Muhammad Ali Mashi, the executive director of GIOPINI
Muhammad Ali Mashi, the executive director of GIOPINI

In 2015, the World Health Organisation, WHO, ranked Nigeria number 3 in a list of 22 countries with the highest prevalence of tuberculosis in the world; over 140,000 persons die annually across Nigeria from tuberculosis-related ailments and the country has the highest figures of TB positive persons in Africa

And although there are hundreds of TB healthcare centers providing free diagnosis and treatment to the TB positive persons across the country, getting patients to present themselves at such centers for diagnosis and subsequent treatment, was a daunting challenge.

With the introduction of Global Fund’s Active Case Finding, ACF, system for tuberculosis patients which entail a house-to-house search for TB positive persons, many more cases of tuberculosis are being discovered, diagnosed, and treated of the communicable disease, across Nigeria.

In Kano state, which is one of the 22 states in Nigeria where the Global Fund’s ACF campaign against TB is being implemented, the system has resulted in a tremendous increase in the discovered cases of TB, with more and more patients being discovered by the various community TB workers spread across 12 local government areas where the ACF is being implemented.

In Albasu LGA, the Active Case Finding project is being implemented by the Global Fund in a partnership with Global Improvement of Less Privileged Persons, GIOPINI, a community based organization, CBO, working with health workers across five wards of the LGA including Albasu, Tsangaya, Saya-Saya, Panda and Faragai.

In an interview with African Newspage, Adamu Yusuf Tsangaya, the deputy control officer of the Kano State Tuberculosis and Leprosy Control Programme said the ACF project became necessary when they realized that despite the presence of hundreds of health centers across the state,
providing free diagnosis and treatment for TB positive persons, there was low turnout of presumptive TB patients.

“Presumptive TB positive persons were not coming forward to report themselves at the various health centers,” said Tsangaya. “Therefore, we introduced ACF under which community TB workers go from house to house to identify presumptive TB patients, take samples of their sputum and carry
out diagnosis and if found to be positive, provide free medication to them at their door steps.”

Tsangaya, said as a result of the introduction of the ACF project, just 6 months into its implementation, the figures for identified TB positive persons had risen tremendously in Kano state. “More and more TB positive persons are being identified, diagnosed and treated,” he said.

“Some men are of the habit of preventing their wives from taking their children to hospital for various immunizations which protects children from diseases like TB. The government is investing a lot of money into immunization hence the need for parents to ensure their children get immunized in the routine immunization exercises, which is free…

Speaking during a community stakeholders meeting in Tsangaya village, the executive director of GIOPINI, Muhammad Ali Mashi, said it was incumbent upon religious and traditional leaders to ensure mass awareness on tuberculosis as well as the ongoing Active Case Finding project being
implemented in their communities.

“There is need for mass mobilization to create awareness among community members and it is incumbent upon our traditional and religious leaders to ensure everyone is reached. Medication is free and it is an opportunity that you might not have again so it is better you make good use of it.

“And TB patients that have been placed on drugs must be monitored to ensure they continue to take their drugs as their failure to successfully finish their medication will have devastating consequences on not only themselves but also those around them, who may also end up being infected with the
disease,” said Mashi.

Also speaking during the stakeholders’ meeting, the head of department (health) in Albasu LGA, Abdulrazak Idris Usman urged everyone in attendance at the meeting including traditional and religious leaders to use their various spheres of influence and public gatherings including mosques,
wedding and naming ceremonies as well as funerals to enlighten and educate community members on TB and its dangers.

“Some men are of the habit of preventing their wives from taking their children to hospital for various immunizations which protects children from diseases like TB. The government is investing a lot of money into immunization hence the need for parents to ensure their children get immunized in the routine immunization exercises, which is free,” he advised.

While also speaking at the event, Hussaini Usman, the TB and leprosy supervisor in charge of Albasu LGA, said prior to the introduction of the Active Case Finding system, they were finding it difficult getting patients to come to the health centers and report potential TB cases adding that the ACF had significantly increased the figures of identified TB positive persons in the LGA by 85%.

A cross-section of participants at community stakeholders
A cross-section of participants at community stakeholders

Tijjani Abdulkadir is the village head of Saya-Saya, one of the 5 wards of Albasu LGA where GIOPINI is implementing the ACF project. And while speaking during a similar stakeholders’ meeting in his community, he also said the CBO’s intervention had led to a tremendous increase in the discovered number of TB positive persons in his community.

Abdulkadir, pledged to ensure all identified TB positive persons were placed on medication and that they continue to take their medication until they were fully cured.

“We will provide all necessary support to ensure TB positive persons are identified and treated,” said Ibrahim Sabo Mohammed, the village head of Panda, where GIOPINI is also implementing the ACF project. “Health workers should always reach out to us when necessary to ensure smooth running of their work. We are also going to organize another meeting to re-orient our people on TB and how they can access free medication for the disease.”

African Newspage’s finding reveals that after the launch of Global Fund’s 2-year Active Case Finding project being implemented by GIOPINI in Kano Municipal, Gwale and Albasu LGAs of Kano state, barely 6 months ago, figures for identified and treated cases of TB have risen tremendously with patients now willing to make themselves available to community TB workers for diagnosis and treatment.

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