In Myanmar, tuberculosis (TB) especially affects the urban poor and migrant populations. To address the epidemic within these groups, the Ministry of Health and Sports, supported by 3MDG and partners, sends mobile teams out to find new cases of TB. There are nine mobile teams working around the country.
During the first six months of 2016, 109 mobile visits were carried out in hard-to-reach locations and ‘peri-urban’ locations, which lie between urban and rural areas. Teams also visited prisons, worksites and mines.
To learn more about a typical day, we followed one of the mobile teams to Yangon’s Thingangyun Township as they tackled this contagious, but curable, disease.
Dr Tay Thun Zar arrives in the morning with his colleagues to set up the chest X-ray machine. Today in Yangon’s Thingangyun Township, he will test about 100-200 people. He normally finds 2-3 cases of active TB – but has sometimes found as many as 15.
The first patients start to arrive – young and old. Some have experienced TB-related symptoms such as weight loss, night sweating and persistent coughing…
… And some just come to get tested, to make sure they are TB-free. This is important because a person who may have the disease in its early stages, without symptoms, still needs treatment and can transmit the disease to others. That’s why screening is encouraged and is free-of-charge for everyone.
The work of the mobile team runs very smoothly. First the patients register with staff from the mobile teams, and then they have a consultation to talk about their symptoms and have any necessary tests.
The primary screening diagnostic method used by mobile teams to detect TB is chest X-ray. If TB is suspected based on the X-ray, patients will be referred to the township health department for a sputum examination. Sputum is a thick fluid made in the lungs, and laboratory technicians can examine it under a microscope to confirm a TB diagnosis.
It takes only 5-10 seconds to find out the result from the chest X-ray. The mobile clinic staff analyses the results straight away while patients wait.
U Li Kyaw Lin Tun had TB earlier this year, but he is now fully cured. Today he came to see the mobile clinic’s work with his daughter.
After his chest X-ray is read, the health staff suspects that this man (name withheld) has TB. He gets more information about the disease and treatment begins straight away.
To confirm the diagnosis, he will have a sputum test at the township health department. Because he has had TB before, he will also have another test called ‘GeneXpert’ to test for drug-resistant TB. This is a sophisticated molecular test, which detects the DNA in TB bacteria.
Dr. Tay Thun Zar explains to the patient that the disease is treatable and can be cured, and answers any other questions he might have.
Treatment for ordinary tuberculosis lasts for six months. For some patients, usually due to an incomplete treatment course or poor treatment adherence for a previous episode of TB, the disease can develop into a multi-drug resistant form. Treating it takes up to 20 months and can have severe side effects.
There is still a lot of stigma related to TB. Improving access to screening and treatment increases the awareness of the disease, and highlights that it can be spread to anyone.
Dr. May Thu Soe (right), who is a doctor with the mobile team, had TB last year. After sticking to her treatment, she was cured after six months. Now she can share her experiences with her patients.
TB can affect anyone. Fortunately, everyone - no matter what their background - can walk in to a TB mobile clinic and get tested by friendly, welcoming health staff.
Learn more about active case finding in Chin State.
