CRATHA-22 Project

CRATHA-22 (Create Awareness for TB and HIV/AIDS -22) project is a small grant project supported by Sub Recipient Uganda Stop TB Partnership under Principal Recipient TASO NFM 3.

The project’s main focus is to integrate Tuberculosis (TB) in all ongoing primary health care activities in Mukono Municipality. This project kicked off in July 2022 and is focusing on Central Division and Goma Division of Mukono Municipality working with 5 Government health facilities that Include: Mukono General Hospital HC IV. Goma HCIII, Nantabulirwa HC II, Nyanjja HC II and Kyungu HCII.

Mukono Municipality has the highest cases of TB because of its urban nature and the developing industrial area that employ people from all over the country as well as foreigners from India, China , Ethiopia, South Sudan and Democratic Republic of Congo.

The Mayor of Mukono Municipality Mr Erisa Mukasa Nkoyoyo giving opening remarks during the CRATHA-22 orientation meeting for Municipality and District leadership. The project received a warm welcome.

Highlights of the Mukono District and Municipality Leadership Orientation Meeting.

The DHO highlighted that they are having a very big load to carry as a District. The district has 23 DTUs, 4 HSDs one hub at Mukono Generak Hospital. There’s 3 GeneXpert Machines at St Nazigo, Nagalama and Mukono General Hospital.

The District population now stands at 700,000 and they expect to get 6 cases per quarter. Mukono Municiplaity which is the target of this project, has only 3 DTUs doing TB screening and TB case detection.

She mentioned that Defeat TB supported Health Workers with capacity building to learn how to screen. However, the community TB component remains a problem especially among men whose health seeking behavior is poor.

She mentioned that the second hotspot to consider in Mukono District is Mukono Highlands (fisher folks) as a high risk target. There are 3 DTUs in this area. Out of the 3 DTUs, Kkome Island has a microscope but the other 2 DTUs don’t have microscopes. Transport in this area is hard as a client has to hire a boat at 100,000= (One Hundred Thousand Uganda Shillings) which is unaffordable. Kome Island is a high spot. She emphasized that in Mukono Municipality there is no Xray. There is one Xray at Mukono Church of Uganda a PFP and the xray is paid for. The Municipality needs a public Xray that can be accessed.

3 by 1 campaign for TPT is starting in community awareness. There is need for 70% TB uptake to move upwards.

She said the challenge on Treatment success Rate quarters of October, November, and December-July, August and September were beyond target at 92% from 90%. Defeat TB brought in Community Linkage Facilitators and it helped to follow –up. After Defeat TB close out, the performance has gone down to 80%. Many clients are diagnosed with TB but refuse to be initiated because of myths. We need to strengthen the community arm, involve Health Workers in the community activities for sustainability because they are the ones to remain with these clients.

Our DTOS have been updated on how to diagnose just as we are considering Mukono highlands including the fishermen who stay in that area.
There is a bit of improvement on TPT treatment
We hope that most of the part of Mukono can be covered
TB has three characteristics; it is airborne, it is common in urban areas, it is a community disease.

The Executive Director of Kuboresha-Africa making a presentation about the TB Global and National burden as well as introducing the CRATHA-22 project.

Highlights of the District TB and Leprosy Supervisor

TB transmission is very easy since it is airborne. It is a disease of urban spots. Almost 50% plus of TB cases comes from urban spots. TB is a disease of the community therefore the community concept of Kuboresha –Africa is a good innovation. DOT facilitation has been poor in Mukono. There is need to find patients at home, visit households, educate people at household level about TB, let people continue treatment after the initial 2 months phase when they start feeling better. Select Treatment Supporters to look at people in their households and do training to rule out TB. Look at children under 5 years who are prone should be given TPT as well as PLHIV. On diagnostics, out of 23 DTUs only 21 have microscopes. There are 3 GeneXperts but one of culture is not available. We have cases of MDR-TB patients coming back and testing MDR positive, we are wondering why? Samples are transferred to Wandegeya. After DST, they come back after one year they test positive.