Stop TB Partnership

Scaling up of MDR-TB case detection in Lira


24 February 2015 - Kampala, Uganda - Even though Uganda has achieved the millennium development goal in fighting TB, Multi Drug Resistant TB (MDR-TB) still remains a growing concern for the nation. This is especially so in the Northern part of Uganda. Lira district one of the districts in northern Uganda remains a hotspot for MDR-TB. This may be attributed to the peri-urban status of the district as it continues to attract a number of people for commercial as well as other strategic reasons.

Until 2009, only Kitgum district hospital had the capacity to treat MDR TB and all patients from northern Uganda with MDR-TB symptoms could only access treatment and care from Kitgum. The human resources and facilities were not sufficient to match the case detection and case notification burden. The remoteness and poor transport network of the region was also another factor that hampered case detection as all sputum samples depended on the hub system for transportation to the central TB laboratory in Kampala. As such, case detection in such a centralized MDR-TB management system was generally not adequate.

In February 2014, The USAID funded MSH managed TRACK TB project started implementation of MDR-TB management and control activities in Lira district. The project is mandated to increase case detection and treatment success rates in focus areas to meet national targets for reducing the burden of TB, multi drug resistant TB and TB/HIV.

TRACK TB trained health workers in the TB unit at Lira Regional referral hospital in MDR TB management and control. The health workers then trained fellow health workers in all other non TB handling departments to create awareness about MDR-TB. They were also trained on methods to systematically identify people with suspected MDR-TB within their units. They carried out extensive advocacy and awareness rising to educate people about MDR-TB symptoms and to reduce stigma associated with the disease. The key message was that all health workers at the hospital should be cautious in making MDR TB diagnosis. Therefore, diagnosing of MDR TB should not be left to the TB unit alone. Other departments can also detect MDR-TB. As such this encouraged other department to be vigilant on detecting MDR-TB.

Barriers to accessing diagnostic services were reduced by empowering the health workers in other non TB units to be able to suspect, request for a sputum sample that is taken to the laboratory for probable MDR TB.

As a result of this initiative 26 patients have so far been detected. With 12 patients being detected in the period October to December 2014. Additionally, all patients in the TB register suspected to have MDR TB have had their samples taken to the laboratory for GeneXpert testing.

This initiative has generally eased and improved case detection and facilitated improved access to MDR- TB care in Lira