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New integrated TB/HIV clinic brings critically needed care to overlooked area

Located at the junction of Malawi’s main rail line and the busy M8 highway, the southern town of Balaka is a small but active transportation hub, visited daily by people travelling for business or pleasure.

It is a stopover between Lilongwe, the national capital, and Blantye, an important commercial city further south. Although there is little attention given to Balaka as a town, it is in the spotlight health-wise as it has the highest number of Tuberculosis (TB) cases nationally. It is this fact that has led to the construction of a new TB/HIV clinic at the Balaka District Hospital.

Serving close to 300,000 people, the Balaka District Hospital is located in an area of Malawi that is facing a high burden of TB. ©German Embassy Lilongwe

Serving close to 300,000 people, the Balaka District Hospital is located in an area of Malawi facing a high burden of TB. ©German Embassy Lilongwe

Despite the fact that it is curable and preventable, TB was among the top 10 causes of death worldwide in 2015. The World Health Organization reports that globally, 10.4 million people were diagnosed with TB in 2015, an average of 28,500 each day. During the same period, 1.8 million died, including 400,000 people living with both HIV and TB.

“People living with HIV are at a greater risk of contracting TB because of their weakened immune system,” says Thomas Bizeki, the District TB Officer at the hospital in Balaka.  “Here in Malawi, 60 to 70 per cent of TB cases occur in patients whose immune systems are already compromised by HIV.”

In 2015, a total of 8,900 TB-related deaths were recorded in Malawi. Of these, 6,600 people were also living with HIV.  To compare, Canada had 1,639 active TB cases in 2015, 1.6 – 5.8 per cent of which were also HIV positive. That adds up to 95 people on the upper end of the scale, many of whom have easier access to treatment and care.

Thomas adds that one of the problems in controlling TB in Balaka is the long distances people need to travel for TB screening. Many arrive in the town on foot from surrounding rural areas, and even after they reach the hospital, they still have further to go:

“At least 100,000 people come for TB screening every quarter – of these, 200 are diagnosed with the disease. Up until recently, patients had to travel an additional 2 kilometers from the hospital to the outpatient clinic for testing or to get their results. Many patients are unable or unwilling to travel the extra distance,” explains Bizeki.

It is against this background that IZUMI Foundation, an American non-profit organization provided funding to Dignitas International to introduce an integrated TB/HIV Clinic within the grounds of the Balaka Hospital.

“We think this clinic offers an ideal environment for people seeking TB and HIV care. The Balaka clinic has 5 separate rooms for patient registration, consultation, laboratory services, drug dispensing, and HIV testing services,” says TB/HIV Coordinator Harry Kaonga.

With support from the IZUMI Foundation, Dignitas constructed a new TB / HIV clinic on the grounds of the Balaka District Hospital. The town of Balaka and the surrounding area have among the highest rates of TB in Malawi

With support from the IZUMI Foundation, Dignitas constructed a new TB / HIV clinic on the grounds of the Balaka District Hospital in 2017. The town of Balaka and surrounding area have some of the highest rates of TB in Malawi. © Dignitas International

Since the completion of the construction of this well-ventilated clinic in early March 2017, 388 patients have registered for TB treatment. Of these new registrations, 189 (49 per cent) are also living with HIV.

IZUMI has also funded the construction of a similar TB clinic in Machinga District and supports services at Dignitas’ Tisungane Clinic in Zomba. This is in addition to funding TB-related mentorship and support for 600 Health Care Workers.

“With IZUMI’s support, Dignitas has been able to offer other TB services including lockable drug cabinets, surgical masks and respiratory masks in all of our facilities,” said Kaonga. “The clinics, the training, and the equipment translate to big results: In 2016 alone, we reached 1,300 new TB patients – 800 of them were also living with HIV. We could not have accomplished this without this support.”

March 24 is World TB Day. Find out more about how Dignitas International is helping fight TB and HIV in Malawi here.

Dignitas InternationalNew integrated TB/HIV clinic brings critically needed care to overlooked area