Manage latent TB to reduce new active cases

Despite the encouraging progress in fighting Tuberculosis (TB), it remains one of the leading causes of death globally, with an estimated 30 deaths and 223 people getting sick with TB every day in Uganda. 
As hazardous as it is, TB is curable and preventable. In 2020, global statistics showed that among all the TB cases, 6.7% were among people living with HIV.

Uganda being one of the 30 countries with the highest burden of TB/HIV co-infection, with an estimated incidence of 200 cases per 100,000, management of latent TB or TB prophylaxis has been emphasized among people living with HIV which has greatly reduced the TB/HIV co-infection. 

With the above initiative, it has come to my notice that the TB burden has increased among people who are HIV-negative. When a person’s immune system is weak, latent TB infection can quickly progress to TB disease, like we all know that not only HIV can lower someone’s immunity.

There are other diseases like type 1 diabetes, rheumatoid arthritis, and inflammatory bowel disease among others including behaviours like smoking, alcohol consumption, stress, and not enough sleep and rest. Therefore, there are many people in the community who need to receive TB prophylaxis in order to prevent the development of active TB and thus reduction of new TB cases.

People with latent TB infection do not feel sick and do not have any symptoms, they are infected with Mycobacterium tuberculosis, but do not have TB disease. The only sign of TB infection is a positive reaction to the tuberculin skin test or TB blood test. In this regard, sensitization of the community and availability of these testing services at the health facilities as well as in community outreaches will be of great importance and thus linkage for management.

While managing latent TB, isoniazid (INH) is taken once daily for 6 months or a combination of isoniazid and rifapentine (3HP) which is administered once weekly for only three months; remember the dose is given according to body weight as directed by the manufacturer.

The author; Aisha Naava, is a trained Nursing officer working with Kawolo General Hospital