Tuberculosis is a leading cause of death and disease in Somalia. The 2021 World Tuberculosis Report states that there has been a marginal increase in the estimated incidence of tuberculosis in Somalia, from 258 per 100,000 people in 2018 to 259 per 100,000 in 2020. However, the mortality rate in Somalia remained at 68 per 1000. Effects of COVID-19 on the tuberculosis program Reporting cases and treating them early is vital to stopping the spread of TB. However, the slight increase in the number of cases reported in Somalia in 2020 and the global tuberculosis notification dip, which rose from 7.1 million in 2019 to 5.8 million in 2020, can be largely attributed to the COVID pandemic. -19. Global mortality has also risen over the same period as people around the world have avoided visiting health facilities for fear of being infected with COVID-19. In 2020, an estimated 1.3 million HIV-negative people died from tuberculosis, up from 1.2 million in 2019, and an additional 214,000 HIV-positive people died. Of the cases reported in 2021, 17,204 were drug-sensitive cases, while 299 were drug-resistant cases. “Somalia’s tuberculosis program is now gradually recovering from the effects of the COVID-19 pandemic, with 17,503 cases of tuberculosis reported in 2021, compared with 17,200 reported in 2020,” said Dr. Abdiaziz Mohamud Shire, National TB Program Director. Federal Ministry of Health and Human Services. “Although we are making progress, we need even more support in the form of GeneXpert engines and promotional activities. “Both are important in identifying incidents.” Limited awareness and misdiagnosis Despite its prevalence, healthcare professionals are still losing track of early diagnoses and people like Adow Adan Abdi are still unaware of the symptoms of tuberculosis. About a year and a half ago, Adow started coughing a lot, but thought he probably had a simple cold. At a clinic in Tiyeglow, doctors gave him antibiotics and cough syrup, but only after two weeks of visits. Seeing no improvement, they referred Adow to a private clinic in Baidoa, Bay Area, for a blood test, where they confirmed he had tuberculosis and was prescribed medication as treatment. However, Adow had to buy it himself. For the first four months, the symptoms subsided, but by the fifth month, Adow had returned to Tiyeglow as his cough had returned. He lost his appetite and lost more weight. His condition worsened and he even started coughing up blood and pus. When Adow became seriously ill, his family took him to the Manhal TB Center in Waberi, Mogadishu, for support. They took a sample of sputum and examined it and then referred it to the Forlanini Multi-Drug Resistant-Tuberculosis (MDR-TB) Center for Tuberculosis (MDR-TB) for treatment, where it finally received the proper attention. Adow, who is still in Forlanini Hospital, is relieved that his medication is helping him, along with counseling. He has even made good friends with the hospital staff, who he says is very helpful, and with other patients recovering from tuberculosis. They eat their meals together and discuss their experiences, which helped him feel much better. After three months of treatment, Adow begins to gain weight. Although he felt ready to leave, the hospital staff asked him to stay until the inflammation in his joint had subsided. Adow says he believes more people need to know that tuberculosis is curable and preventable. It is grateful that bodies such as the WHO support health facilities with state-of-the-art TB testing equipment and calls on decision-makers to consider supporting patients with dietary TB. New technology used to control tuberculosis The WHO has supported the Somali Federal and State Ministry of Health to use rapid molecular diagnosis as the primary tool for diagnosing tuberculosis. In 2021, half of all probable cases of tuberculosis in Somalia had access to GeneXpert test, while 61% of all cases of positive sputum coatings were diagnosed using GeneXpert test. In 2021, Somalia had 99 Tuberculosis Management Units (TBMUs) and 50 GeneXpert machines distributed throughout the country. Twenty-two GeneXpert machines were used to diagnose both tuberculosis and COVID-19. The three MDR-TB centers in Mogadishu, Hargeisa and Galkayo that treat multidrug-resistant tuberculosis operated normally without any significant challenges being reported. Culture laboratories in Hargeisa and Mogadishu continued to perform line 1 and 2 (LPA 1 & 2) detection tests to detect mycobacterium tuberculosis and drug resistance, under the supervision of the Uganda Transnational Reference Laboratory. In 2021, 89% of TB cases in Somalia were tested for concomitant HIV infection. Of these, only 0.9% were found to be simultaneously infected. The Department of Health, the WHO HIV team, and UNICEF provided access to antiretroviral therapy (ART) in approximately 64% of TB cases with concomitant infections to assist in the treatment of HIV. Collaboration by partners “Our investments so far have reaped double the benefits of saving lives by testing for both tuberculosis and COVID-19,” said Dr Mamunur Rahman Malik, WHO spokesman in Somalia and head of the mission. “By further scaling up our investment in TB prevention, we can ensure that all Somalis, everywhere, know more about how TB is spreading and have fair access to prevention and care.” This will help us reach the Universal Health Coverage “. The World Fund is financially supporting the TB eradication program in Somalia through World Vision International, which is the main recipient of the funding. International and local non-governmental organizations manage the TB centers as sub-recipients of the World TB Fund grant, while the independent monitoring body oversees the entire program. The TB Coordination Team, which brings together the National Tuberculosis Program (NTP), the WHO, World Vision International and key implementing partners, remains the program’s decision-making body. It reviews tuberculosis eradication activities twice a year to address any challenges the program faces. As the technical body supporting the national TB program, the WHO supports capacity building, drug management, development of treatment and reference guidelines, and data management, and guides World Vision in implementing strategies.
