As part of its continuous efforts to enhance the health sector in Somalia, Qatar Red Crescent Society (QRCS) has commenced the operation of the Tuberculosis and Multi-Drug-Resistant Tuberculosis (TB/MDR Center in Banaadir Region, Mogadishu, in coordination with the Somali Ministry of Health (MOH), the World Health Organization (WHO), World Vision, and the Organization of Islamic Cooperation (OIC).
The centre is the only TB treatment hub in the eastern, central, and southern parts of the country, with just one counterpart in Hargeisa, northern Somalia. Access to TB centres in neighbouring countries is largely limited.
By contributing to Mogadishu’s centre, QRCS seeks to reduce and control the morbidity and mortality caused by TB and MDR-TB by introducing and scaling up TB and MDR-TB intervention, diagnosis, and management.
Lasting for one year, the first phase of the project will cost around $ 445,000 (QR 1,620,000), co-funded by QRCS and World Vision. It targets treating 1,640 TB and MDR-TB patients and protecting 30,000 patient close-contact families.
The activities done so far involved full rehabilitation, equipment, and furnishing of the centre’s buildings, as well as operation, establish of the TB management team, promote capacity building for health personnel, patient support, operational TB/MDR-TB research, and medical and paramedical training.
After registering the patients, samples were taken and sent to the reference TB laboratory in Kampala, Uganda, where they will be tested for disease verification and diagnosis.
Under an agreement with the MOH National Tuberculosis Program (NTP), 18 patients were sampled, and the examination results are expected within two weeks. Confirmed patients will undergo a two-year treatment programme. More patients will be enrolled over the coming few weeks.
This burden of TB/MDR-TB is very high in the country. According to NTP data, MDR-TB was revealed by 5.6% among new cases and 46% among previously treated cases. These MDR prevalence rates would place Somalia as one of the highest MDR-TB burden countries in the region.
The nearest TB management centres for TB/MDR-TB Somalis are in Nairobi and Kampala, where only patients who are legally residents of these countries are enrolled.
Although many factors could be blamed for drug resistance in Somalia, the main causes in both new and previously treated TB cases are likely poor drug quality, poor storage conditions, wrong dosage, absence of or non-adherence to guidelines, poor training, absence of government regulation.
The sad part of the scenario is that 86 confirmed MDR cases were left in the general population without any medical intervention or treatment. The situation of these cases is so critical that no one is aware of their whereabouts, and it is feared that most of them are still alive and spreading MDR infection in the communities or, even worse, might have migrated to neighbouring countries or the Arab region as well.