ACT-TB Project

The ACT-TB ( Advocacy and Contact Tracing to End TB) Project is a new project started by Kuboresha-Africa working in partnership with Mukono Municipality. The project is to focus on two Divisions of Mukono Municipality namely: Central Division and Goma Division with a total population of 202,142 projected (2015-2020) source: Mukono Municipality Development Plan 2020/2021-2024/2025. This is projected to be the first phase of the ACT-TB project. The second phase that may run concurrently depending on funding, will work in Kira Municipality Wakiso District and the third phase will cover Kawempe and Nakawa Divisions in Kampala District. The fourth phase will go to the Ankole and Kigezi regions. All these phases will be focusing on engaging communities to end TB.

The project is going to work in 5 parishes of Goma Division and 4 wards of Central Division with a total of 79 villages. This project is awaiting support from TASO Global Fund grants to focus on TB in the District. Much as many implementing partners have worked in the District, few of these have concentrated on TB. No partner has prioritized community engagement on TB, this leaving a gap in case notification and awareness on TB. There is a huge gap countrywide on TB/HIV integration as well having TB included in PHC priorities in all Districts of Uganda. TB/HIV collaborative activities started in 2006 but it has always remained at facility level in some Districts during ART clinic days with no much awareness of integration beyond this point.

A gap analysis has already been done in all the above mentioned Districts and regions where the findings speak of a need to focus on engaging communities in TB awareness and have all CBOs working on HIV/AIDS integrate TB in their interventions as well as having communities participating in District planning and budgeting meetings to enhance bottom-up planning process in order to ensure that communities are at the centre of the planning process. This project is having an opportunity of the introduction of the Parish Development Model whose structure has Parish Development committees that bring everybody at the community level on board. Our resource mobilization team will continue to write proposals to this effect until we go through all the phases committed to end TB countrywide and to feed into the National TB and Leprosy Division Targets for meaningful community engagement.

Goma Division:

• Bukerere
• Nyenje
• Misindye
• Seeta
• Nantabulirwa

Central Division

• Ggulu Ward
• Ntaawo Ward
• Namumira-Anthony
• Nsuube -Kanga

ACT-TB Focus

• Active case finding
• Integrating TB into all ongoing health interventions
• Linking CSOs and CBOs to District Local Government Budgeting and Planning
• Forming community advocacy platforms
• Empowering communities in community-based monitoring
• Integrated TB screening in COVID-19 home based care using the ICF (Intensive Case Finding) guide
• Work with health facilities to map TB hotspots and conduct targeted TB screening outreaches
• Support home delivery of TB medicines using the CHWs
• Contact tracing
• Training communities in ACSM
• Engaging TB survivors
• Working with houses of worship to have them disseminate TB messages every Friday, Saturday and Sunday
• Using public transport system to create TB awareness
• Engaging musicians
• Ensuring social protection initiatives with introduction of Income Generating Activities
• Formation of association of TB survivors into revolving funds
• Integrating TB interventions with COVID-19
• Making Village COVID-19 Task Forces integrate TB and COVID-19 in their tasks

ACT-TB Project Strategic Focus and Coverage in Uganda

ACT-TB IN KAMPALA DISTRICT

Kampala is the capital and largest city of Uganda. The city proper has a population of 1,680,000 and is divided into the five boroughs of Kampala Central Division, Kawempe Division, Makindye Division, Nakawa Division, and Rubaga Division.

Kampala Central Division is one of the five divisions that make up Kampala, the capital of Uganda. The city’s five divisions are: (a) Kampala Central Division (b) Kawempe Division (c) Lubaga Division (d) Makindye Division and (e) Nakawa Division.

The ACT-TB project is working in two Kampala Capital City Parliamentary Constituencies of Nakawa and Kawempe with a population of 657,112 according to the data analyzed as per the WHO/JMP (JMP, 2017) sanitation service levels.

Wakiso District is made up of two counties of Busiro and Kyadondo. It has seven constituencies, three in each of the counties and one in Entebbe Municipality. It also has 15 Sub Counties, one Municipality and six Town Councils.

Kira Municipality

Ankole Region

Kigezi Region

TB News Highlight

According to the Chief of Party Defeat TB Project Dr Abel Nkolo, while the TB disease is curable, many people are reluctant to seek treatment and where they do, many don’t complete the dosage. He said Uganda is one of the few countries in the world with high TB disease burden and more must be done to combat the prevalence.

“In the last few years, the WHO reported that tuberculosis infection rates rival HIV-AIDS infections as a leading cause of deaths. Several people with TB do not know that they have the disease. Uganda is one of the 30 high TB-HIV burden countries in the world with TB prevalence which is 1.5 times higher than the previously estimated by WHO,” Dr Nkolo said.

He said TB is posing a huge problem because patients do not adhere to the treatment schedule. “About 10 percent of patients with drug sensitive TB die every year and about 15 percent abandon treatment and remain in the community. About 80,000 people in Uganda develop tuberculosis every year but about 4 percent remain undetected. They stay in the community and continue to spread the disease. Every untreated TB patient can spread disease to about 15 others every year. The good news is that TB is curable and treatment is freely available at all TB treatment facilities in the country. To identify and minimize TB infection among all people, there is an urgent need for individual and collective responsibility and the time is now,” Dr Nkolo warned.

He said in September 2018 when they did TB screening outreach in the New Tax Park in Kampala they found 22 patients with TB out of the 366 people who were screened.

“This for TB is a very high number in one location given that it is a highly infectious disease. These findings highlight how close TB is to each one of us and the call for personal and community vigilance,” he said.

Dr Kenneth Mutesasira, the senior technical advisor for the USAID Defeat TB Project, said community sensitization must be done and more people be advised to seek medical attention early.