A Right Care programme counsellor in Tân Bình District visits a resident’s house to provide information about free TB screening. — VNS Photo Anh Thơ

Gia Lộc

HCM CITY — Six months after receiving a free X-ray and sputum test from HCM City's Right Care programme, a male patient who tested positive for tuberculosis (TB) was cured of the disease. 

"My family members were also tested, but luckily they didn't have it,” said the man, who declined to be named.

During medical treatment, the man, who had experienced a high fever and bouts of coughing, received assistance from a Right Care programme counsellor at Gò Vấp District's Health Centre where he lives.

“Before my one-month supply of medicine ran out, the counsellor visited my house to ask me to return to the treatment centre to continue the medicine,” the man said.

Dr Nguyễn Trọng Hòa, head of Gò Vấp District’s Health Centre, said the programme counsellors had been instrumental in helping to reduce the rate of TB patients who quit treatment.

“The counsellors help the centre find TB patients in the community who are unaware that they have contracted the virus,” Hòa said, adding that the number of TB patients had increased since the provision of free testing.

From April 2014 to May 2015, when Right Care, operated by the HCM City Public Health Association, was first piloted in the district, 107,771 people received free screening.

Most of them were in high-risk groups, including relatives who live with TB patients; those who live in or near areas with many TB patients; others living in areas with high population density; poor labourers; people with HIV; drug addicts; and others with a chronic disease.

During this period, among the 107,771 patients, 40 patients were diagnosed with TB, an increase of more than 10 per cent compared to 2013. All 40 patients continued their treatment and did not quit, he said.

Dr Lê Trường Giang, chairman of the HCM City Public Health Association, said the programme was later expanded to six districts because of the positive results. Last year, Right Care was offered in District 7 as well.

In addition, medical staff began taking a mobile healthcare vehicle to sites near patients for X-ray tests. 

If their tests were abnormal, they were then given a free Gene Xpert sputum test which can quickly diagnose pulmonary TB and multi-drug-resistant TB.

As of September this year, a total of 1,703 more TB patients had been diagnosed in the eight districts where the programme now operates.

As many as 1,005 of them were treated at health centres, which offer free treatment to all TB patients in the country.

In seven of the eight districts, the rate of TB patients giving up treatment was less than two per cent.  

“Identifying high-risk groups and encouraging them to receive free X-Rays or Xpert sputum tests have been important factors in trying to detect the remaining 40 per cent of people with TB in the city,” he said. 

Around 60 per cent of people who have contracted TB have already been detected, according to estimates from the HCM City Health Association.  

HCM City has the largest number of TB patients in the country, with nearly 15,000 people treated every year, according to the National TB Prevention Programme.

A nurse taking care of a TB patient at Phạm Ngọc Thạch Hospital in HCM City. — VNA/VNS Photo Đinh Hằng

Latent TB infection

Since the second quarter of last year, the programme has provided TB skin tests for 8,017 relatives of patients who had no symptoms in eight districts. Among them, 2,413 tested positive for TB and 55.4 per cent of them were treated.

“If they are not treated, the latent TB infection will have an increased chance of developing active TB and they could transmit the virus to other people,” Giang said.

According to the World Health Organization, latent tuberculosis infection (LTBI) is a "state of persistent immune response to stimulation by mycobacterium tuberculosis antigens without evidence of clinically manifested active TB".

In other words, if someone has latent TB, they are infected with TB bacteria but do not have signs of active TB disease and do not feel ill. However, they can develop active TB in the future.

“Diagnosis and treatment of latent TB infection can help Việt Nam eliminate TB by 2030, which is the Government’s goal,” Giang said. 

Dr Lê Văn Thể, head of District 1’s Health Centre, said: “The district has seen a decrease in the detection of new TB incidences. I expect that the programme, especially mobile X-ray vehicles, will start in District 1 in the near future.”

Nguyễn Hữu Hưng, deputy head of the city's Department of Health, has asked the city’s steering board for the National TB Prevention Programme to work with the HCM City Public Health Association on a detailed action plan to expand the programme throughout the city.

The plan will be submitted to the city's People’s Committee for approval of funds.

Nguyễn Viết Nhung, head of the National TB Prevention Programme, said the Right Care programme had been very effective in identifying and testing people with TB, a practice that the national prorgramme does not undertake.

Health staff in other provinces and cities have been encouraged to take part in Right Care. The national goal is to have TB prevalence in less than 131 per 100,000 people, and the number of mortalities due to TB less than 10 per 100,000 by 2020.

The aim is also to reduce the number of multi-drug-resistant TB patients to fewer than 5 per cent of the total number of TB patients by 2020.

The country ranks 14th of 22 countries that have the highest burden of TB globally.

Việt Nam has on average 130,000 new TB patients each year, including 5,100 multi-drug-resistant TB patients. About 17,000 people in the country die due to TB each year. — VNS