Tuberculosis Active Case Finding

Public health is so interesting- so different from treating people on a case by case basis!! Here you are dealing with an entire community- and a community problem.

So we are surveying for undiagnosed TB cases. Funny thing is, we have found less than we thought- after 160 surveys, we found 5 active cases. Are the numbers lower than we thought? Are the diagnostics bad? Are people honest about their HIV status? Is the health system working? We are always asking questions.

Our five patients: Alem, Bekelech, Berhanu, Habtam, and Mesfin.

Alem found out she had TB the same time she found out she has HIV. Funny, she's on treatment now and we walk by her house all the time- she beams when she sees us! I think she didn't know why she was sick and must feel a lot better now.

Bekelech is old and really cute. When she got on the scale at the health center, she weighed 40 kg, which is under 90 pounds. She was exTREMEly dramatic about how thin she is, waving her hands around and saying, "I'm not even 50 kg???" Only confirmed in my mind that she really did have TB- consumption- and her body was being consumed away!! She is on treatment now, and has a huge smile every time we come around.

Berhanu has been treated so many times for TB, when he realized he was getting same intensive treatment at the health center instead of going to the TB specialist hospital (the health center ruled out MDR based on his history of meds and negative smears) he was SO disappointed. Amazing to see him- sad, discouraged, pushed around by the health care system so much. He's convinced this round of treatment won't cure him- we've got to keep him encouraged enough not to default off his medications....

Habtam makes her living begging at Mexico, big intersection in Addis. She said, if the people I live with know I have TB, they will kick me out. She also suspects her baby has TB because he is sick, too, so we are getting him checked out. We said we would visit her somewhere else, not at her house, because we don't want to cause problems.

And Mesfin.... came in so sick laying down on the benches outside our office, brought in by his mom. And his mom is crazy, strong personality, with NO desire for anyone from a Christian project to come visit her, just wants her son better. In fact, she has always had a negative view of her HIV positive neighbors, and spreads rumors about them and talks bad about them. How strange that she would come through the gates of our HIV/TB project herself for her son's sake!!