Community Leaders and Tuberculosis Survivors Partner to Increase Uptake of TB Services in Tanzania

TB survivor Samwel Lupelengesha providing health education to community members gathered at Senga dispensary in Geita district. Photo By: Florian Mutasingwa

Tuberculosis (TB) is one of the world’s deadliest infectious diseases, taking the lives of 4,100 people daily. While preventable and treatable, TB disease continues to devastate communities worldwide. One of the challenges to ending TB is the increased need for early detection and treatment. In Tanzania, U.S. Centers for Disease Control and Prevention (CDC) and partners are addressing this challenge by mobilizing TB survivors and community leaders to provide health education and information on TB prevention and treatment services. The partnership also aims to eliminate TB-related stigma.

The partnership began when a CDC implementing partner, Management and Development for Health (MDH), collaborated with Tanzania’s Ministry of Health and the President’s Office – Regional Administration and Local Government (PORALG) – to implement various HIV/TB prevention, care, and treatment services to ensure that eligible patients receive lifesaving TB preventive treatment (TPT) in a timely manner. However, in February 2021, MDH staff observed that many patients with HIV in the Geita Region were missing clinical appointments and not completing the TPT regimen within the recommended six months from initiation. This lack of adherence to treatment guidelines could lead to patients developing drug-resistant TB – a form of TB disease that is harder and more expensive to treat.

The team began problem-solving to find a way to reach patients and increase treatment adherence. Kizingi Madeni, a district TB coordinator in Geita, and MDH staff turned to local leaders and TB survivors for help. These individuals were tasked with providing health education and mobilizing access to free voluntary TB screenings for those in need. Local leaders and survivors led discussions using various forms of communication, including Swahili slang terms, to best explain what TB is, the key symptoms to look for, and invite individuals to be tested. “30 people attended when we held our first health education and TB screening meeting at the health facilities. And among the sputum samples collected and sent to the laboratory, three patients were identified and treated for TB disease,” said Madeni. Working with local leaders and TB survivors proved effective in parts of the district that were experiencing a lack of healthcare providers. These events also raise awareness that early TB detection and treatment reduce the patient’s chance of infecting others in their community.

“We have seen the change. Giving our testimony about being cured of TB has helped us reach many people who are in remote areas and may not believe TB is curable. We want future generations to be free from TB,” said Samwel Lupelengesha, one of the TB survivor volunteers educating the community about TB treatment and prevention.

The partnership between community leaders and TB survivors continues to have an impact. In September 2021, only 69 percent of community members who were initiated on TPT completed the six months treatment regimen. Following the community-level interventions, that number grew to 88 percent by December 2021. Following the pilot program’s success, health officials plan to expand the intervention to other regions of the country with high burdens of TB.