Rising COVID-19 cases stretch Africa’s health facilities

BY STEPHEN TSOROTI

THE swelling number of COVID-19 cases in Africa has led to the over-stretching of amenities, particularly tuberculous (TB) facilities.

Partners in combating tuberculosis (TB) have recorded that field staff are being overwhelmed due to COVID-19 and that normal services are not being delivered in most African countries.

Hospitals for TB outpatient and inpatient care management have been converted into COVID-19-testing, laboratory staff and infrastructure, have transitioned to focus on COVID testing.

According to a Stop TB Partnership’s rapid assessment with national TB programmes concerning the impact of COVID-19 on TB carried out in Zimbabwe, TB health products such as personal protective equipment (PPE) and disinfectants that have sustained the initial COVID-19 response are now running out.

Observations are that COVID-19 is going to impact TB programmes as shifts are going to be seen in access to health facilities by TB clients, limited presumptiveness of TB by healthcare officials due to fear and stigma of COVID-19, diagnosis of TB delayed as COVID-19 is being prioritised and limited capacity of community health workers to carry out their activities.

TB and COVID-19 are both infectious diseases that attack primarily the lungs. Both diseases have similar symptoms such as coughing, fever and difficulty in breathing. TB, however, has a longer incubation period with a slower onset of the disease.

While experience on COVID-19 infection in TB patients remains limited, it is anticipated that people with both TB and COVID-19 may have poorer treatment outcomes, especially if TB treatment is interrupted.

As of yesterday morning, Zimbabwe had recorded 84 COVID-19 fatalities.

Although noting that the TB cases have not increased significantly during this COVID-19 period, Health and Child Care ministry deputy director Charles Sandy said the country has been recommending the combined approach for testing both TB and COVID-19 diseases.

“This entails counselling and screening for all conditions as much as possible. Refill periods for medicines have been extended unless the TB client has some other medical condition,” he said.

TB patients should take precautions as advised by health authorities to be protected from COVID-19 and continue their TB treatment as prescribed.”

Cynthia Mwase, head of the Africa and Middle East Department at the Global Fund, said TB concern during this COVID stemmed from fact that “there is a very high potential of missing one disease over the other, and the second concern being that there is the use of the same diagnostic equipment”.

Mwase said Global Fund was trying to negotiate with countries to ensure that both diseases are tested concurrently.

“It sounds simple in principle, but the operations of doing that are changing every day, they are dynamic and they’re complicated,” she said.

“Four years ago, the Global Fund partnered with the rest of the world to ensure that we find missing cases. We have been worried that globally we were missing just about half of the cases of TB. Half the cases were undiagnosed and we made really great progress in identifying those missing cases, and we are now worried that this COVID-19 could reverse that.”

Access to test kits has been a complication in sub-Saharan Africa. What has stalled quick delivery has been the rate at which the tests kits could be approved in terms of quality assurance, coupled with the rate of production at global level where manufacturing of the kits was adversely affected by the first response to COVID-19.

“We are working as a partnership to ensure that whatever is available now on the global market is equitably shared,” Mwase said.

The Africa Centre for Disease Control and Prevention (Africa CDC) has established a transparent procurement platform, which governments and other institutions working in Africa could approach and procure items.

The online application platform enabled a country or a government or institution, to pick items they needed for COVID-19 response.

“It is pretty much like what you would see in Alibaba or Amazon. You pick what you need and then you check out and you go into the payment platform where Afreximbank is acting as a facilitator to ensure that the payments are secure and to ensure that there is no delay in making money available to the suppliers,” Africa CDC deputy director Ogwell Ahmed said.

The centre envisaged deploying a million community health workers across Africa who will be used to spread correct information to the public, and also act as a smart screening at the community level.

“That way you don’t have to really go through everybody, you go through a certain group of people who have the threshold for needing to be tested. For smart screening, we’re going to be using one million community health workers,” he said.

Ahmed expressed hope that with such measures and facilities, pressure over available resources will be eased.

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