Togo makes progress in the fight against tuberculosis

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Extract from the article: In January 2024, Yao, a 67-year-old planter living in Agou, some one hundred kilometres north-west of Lomé, experienced unusual ailments that landed him in hospital. These included chest pains and unexplained intense fatigue that lasted for a fortnig

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In January 2024, Yao, a 67-year-old planter living in Agou, some one hundred kilometres north-west of Lomé, experienced unusual ailments that landed him in hospital. These included chest pains and unexplained intense fatigue that lasted for a fortnight. After tests, he was diagnosed with tuberculosis. ‘I was surprised and very sorry to find out that I had the disease. I had suffered too much and I wanted to be cured by any means necessary’, he recalls.

In Togo, 30 out of every 100,000 people had the disease in 2023, according to the WHO's 2024 global report on tuberculosis. The country has implemented a number of initiatives to improve the fight against tuberculosis, as Professor Abdou Gafarou Gbadamassi, Coordinator of Togo's National Tuberculosis Control Programme (PNLT), explains: ‘Several combined interventions are enabling us to make progress in the fight against this disease, focusing in particular on case-finding, early detection and the effective treatment of patients’.

At the heart of early detection is the optimisation of GeneXpert machines, which enable sputum samples from patients to be rapidly tested to confirm the disease.This approach, recommended by the World Health Organisation (WHO) as a first-line diagnostic tool, has made a significant contribution to strengthening case detection in Togo. Until 2020, the country had just 15 GeneXpert machines at 14 sites, rising to 52 sites by 2024.

Professor Gbadamassi is delighted with this development, which he says has enabled us to make great strides: ‘Thanks to this significant improvement in the GeneXpert fleet, early case detection has been improved, from 72 hours to 24 hours throughout the country.This is helping to move our country towards the eradication of tuberculosis.

Other key areas in the fight against tuberculosis include community involvement to ensure patient-centred treatment, free treatment for all forms of tuberculosis, and nutritional support for the most vulnerable patients.

Thanks to the availability of a machine at the Centre hospitalier préfectoral (CHP) d'Agou where he was received, Yao was able to be placed on treatment quickly. After the first few weeks of treatment, which were difficult because of the heavy nature of the treatment, he felt that his situation was improving. ‘The products made me very weak to begin with. After the first two months, I did an initial check and the results were negative.I had further tests in the fifth and sixth months, when I was declared cured of tuberculosis.I suffered so much from it at the start that I was convinced the disease would kill me’.

In June 2022, a strategy known as ‘FAST’, based on active research at four sites in the Agoè Nyivé and Golfe districts of Lomé, enabled the number of cases of tuberculosis detected to pass the 3,000 mark from 2022 (reaching 3,041 cases in 2022, 3,065 cases in 2023 and 3,129 in 2024), compared with 2,312 in 2020 and 2,418 in 2021.

From 2020 to the end of 2023, an investigation project contributing to the elimination of tuberculosis in Africa also studied contagious patients in 35 Diagnostic and Treatment Centres (DTCs), enabling early detection of patients suffering from tuberculosis and providing preventive chemotherapy treatment to those free of the disease, including children under the age of 15 and people living with HIV.Since 2024, this intervention has been extended to the 55 other CDTs thanks to support from the Global Fund.

Yorouma Djobo, CDT Focal Point at the CHP d'Agou, has seven years' experience as a health worker treating TB patients, and provides essential advice to patients.He is responsible for screening, initiating treatment and monitoring treatment for TB patients in the Agou health district. Yorouma sees an average of 3 TB patients every month, and emphasises the role of the family. ‘Our role is to make sure that everyone who is screened receives treatment and recovers their health.  Once the family has understood the harmful effects of the disease, they become our main support and take charge of the patients‘ treatment, taking on board the advice given to the patients in order to help them’.

In 2022, Yorouma and 95 other focal points were trained in all aspects of tuberculosis, including paediatric tuberculosis, therapeutic patient education, management guidelines and preventive treatment. In the same year, 60 laboratory technicians were trained in GeneXpert stool diagnosis, and in 2024, 65 laboratory technicians were trained in bacilloscopy diagnosis of tuberculosis.

The WHO provides support through the provision of experts, technical support for the development and validation of documents and guidelines, and financial support for key events and activities. At the end of 2023, the WHO also initiated the BBNT approach (initials for Benin, Burkina Faso, Niger and Togo) as a framework for exchanging experiences in the fight against HIV, viral hepatitis, tuberculosis and malaria, supporting field visits to share best practice in these countries.

For Dr Laconi Kaaga, Head of the Tuberculosis Control Programme at the WHO office in Togo, the main aim of the WHO's support is to ensure that ‘every person at risk has access to rapid and effective prevention, diagnosis and treatment of tuberculosis’.

Having regained his health and resumed his work as a planter, Yao encourages the population to seek medical attention if they suffer from a persistent cough, and to follow the advice of the treating staff until they are completely cured. He has a special message for patients' families: ’My family has been essential to my recovery. Without their support, I would have died of tuberculosis!

If a member of your family has this disease, stay close to them, help them to stay motivated and never give up hope.

Source: WHO