PICTS accelerating new TB case finding in Myanmar

Lwin Lwin Thant, CNS Correspondent, Myanmar
Photo credit: Lwin Lwin Thant
More than nine million people around the world become ill with tuberculosis each year. About one-third of them fail to get an accurate diagnosis or effective treatment and are more likely to die from this curable disease. We have to reach this missing 3 million by finding and treating people in the poorest and most vulnerable communities in the world.

There is an urgent need to support innovative and effective techniques to find people with TB quickly, avert deaths, stop TB from spreading, and halt the development of drug resistant strains.

One such project is Programme to Increase Catchment of TB Suspects (PICTS) which was launched by the International Union Against Tuberculosis and Lung Disease (The Union) in Myanmar - one of the 22 TB high burden countries. PICTS was started in seven townships of Mandalay in 2012 in collaboration with the National TB Programme, National AIDS Programme, Department of Health and the public sector, in particular the township health centres.

The PICTS project reinforces case finding and access to diagnosis by increasing community awareness of TB through mass communications, decentralization of symptoms screening, sputum collection closer to the community, and referral to Township Health Centres. It has also initiated the use of new diagnostic technologies such as fluorescent microscopy and GeneXpert, in the public sector throughout the project area.

Some of the positive outcomes of PICTS have been an increase in: (i) the demand for and access to TB diagnosis, (ii) the number of TB cases diagnosed in project area, and (iii) community knowledge about TB. The Union also supports the facilitation of People Affected With TB Network (PAWTN).

Photo credit: Lwin Lwin Thant
A PAWTN member, currently involved with the PICTS programme, said that when his brother contracted active TB disease he saw the disease from close quarters. When the PICTS opportunity came for volunteer training in his township, he went ahead and got himself enrolled. His knowledge about TB increased manifold in the backdrop of his personal experience of his brother going through TB treatment. He believes that knowledge is power and raising awareness about TB in the community will help strengthen TB control and care.

Another PAWTN member said that before joining this network, she was volunteering to support people co-infected with TB and HIV. Although she knew how to help people living with HIV (PLHIV) take good care of their own selves, she knew very little about TB related issues. When The Union announced volunteer training in her township she joined it. Now she actively helps PLHIV co-infected with TB to dispose their sputum, take medicines on time, thus providing them support so that they can complete anti-TB treatment successfully.

The leader of this network said that now people affected with TB have organized themselves as PAWTN to spread awareness, increase referral of PLHIV to TB care centres as required, find PLHIV with presumptive TB earlier and refer them to the right TB care centre, attend to their psychosocial needs to complement adherence, help in contact tracing or bring those back to TB programme who are not able to adhere to anti-TB treatment, among other roles. He said that they have realized how beneficial it is for the community to be engaged in the responses to TB and HIV and they will continue to do so even beyond the ongoing PICTS project. 

Photo credit: Lwin Lwin Thant
Recently, in April 2014, PICTS launched the advocacy meeting with Community Based Organizations (CBO), Self Help Groups (SHG) and Mandalay HIV positive network in Mandalay at Divisional Health Department. With the political and social changes in Myanmar, it is the time when local community based organizations such as social welfare organizations, and faith based organizations are blossoming.  This is due to the support from International NGOs and also inspired by political and social movements.

PICTS's representatives and members from 45 groups of CBOs, SHGs, and HIV positive networks from seven townships in Mandalay discussed about TB case findings and referral system for presumptive TB patients. PICTS volunteers also shared their experience on the success of delivering Health Education door to door and also the difficulties encountered in the process.

The discussions enabled PICTS to set up communication networks with CBOs, SHGs, HIV positive groups and also provide support for trainings with a view to empower communities. 

The main outcome of the meeting was that it strengthened the capacity of PICTS, CBOs, SHGs, Positive networks and National Tuberculosis Programme to communicate and work better to help the local communities.

Lwin Lwin Thant, Citizen News Service - CNS
20 May 2014