Last month a 49 year-old man from a village called Laclubar-Funar in Manatuto district (about 5 hours away from Dili) arrived at Vera Cruz Health Centre in the capital. His local health centre is one hour away from his house, but a river without a bridge means he cannot get there by car. He had been to the health centre a few times but was never diagnosed. Eventually, he was so sick his community carried him in a wooden stretcher to the main village, where luckily his brother (who lives in Dili) could arrange transport to bring him to Vera Cruz. He was diagnosed with TB, and started treatment immediately.
As part of our Household Contact Tracing project, the Maluk Timor TB team went to screen the people in his brother’s house. Screenings focused on those at greatest risk are a safe and cost-effective way to manage TB. In the house, we learned 28 people live together, including seven children. Huge households like this are not uncommon in Timor-Leste. All seven children had been exposed to TB. As children have yet to develop strong immune systems, they are at higher risk of contracting TB. We started them on preventative therapy to reduce this risk, which involves taking a daily tablet for six months.
We are screening additional relatives, and providing education to the family and the patient to increase knowledge about TB. This is an excellent outcome for both the family and the community, as it will slow the spread of the disease.
We are happy to see the patient improving with treatment. The follow-up shows no bacteria in his sputum, which means the treatment works. He must take six months of medication in order to fight all the bacteria.
Many other patients like this man do not know their diagnosis. They may be living in large households, exposing many more people to the deadliest disease in Timor-Leste.
While a small country, Timor-Leste’s rough terrain and poor road conditions make most areas difficult to reach, presenting a significant challenge in eradicating TB. The January-April rainy season makes access even more difficult, as high rivers cut off some communities. Our project, like many health services, is currently limited to Dili, so we cannot screen the original patient’s house in Laclubar-Funar.
With additional support, we can expand our Household Contact Tracing project to rural districts, and in the future support the Ministry of Health to undertake this effort without us.