Hon. Stephen Obitre, Maracha District Chairperson flagging off the campaign before leaders.

Ministry of Health and Maracha District Local Government have launched a campaign to combat surging cases of Tuberculosis (TB) disease in the District.  Community Awareness, Screening, Testing, prevention and treatment to end TB Campaign (CAST TB) conducted in March 2025 revealed 74 cases, with 64 learners while 10 being community members near a primary school screened together with learners.

CAST TB is an approach that focuses on igniting communities for the uptake of preventive and treatment innovations for TB services through community participation.

Ministry of Health has dispatched two mobile clinic vans and two mobile x-ray machines to conduct mass case screening and testing among all school learners, teachers and communities around schools in Maracha District.  TB tasks forces have been activated by the lower local governments.

During the flagging off of the campaignb onTuesday April 22, at the District Headquarters, Hon. Obitre Stephen, Maracha District Chairperson, called for concerted effort in turning around the TB trajectory, in which he implored the sub-counties to uphold the intended activities.

“It is about collective effort. Our success is going to depend on you LC3s (chairpersons), you will be able to support the technical wing in this move,” he said.

“We should be able to ensure we cooperate, we support the team that is going to be on the ground. I am actually happy that the right stakeholders are drawn here in this meeting,” Hon. Obitre added.

Dr. Alex Odama, TB and Leprosy focal person West Nile, commended the district for openness and transparency in the management of the situation and positive response to the TB campaign.

“If we do screening very well it will change the course of direction, the weight in its nature has attracted the country. We thought we were on the track to end TB by 2030 but Maracha has proved us wrong by detecting more cases and now it is changing the direction of every district where to go. 

We are saying in Maracha we are not stopping at schools we should go to all the hotspots, who know we might unearth more hotspots, this what other parts of the country want to learn.”

Mr.  Richard Bayo, Health Disease Surveillance Epidemiologist, said there was a cyclical infection between the communities and schools,  and getting to the root cause of the TB bacteria was key.

“ There is a reservoir somewhere that is being untouched. The outcome is the TB case, as long we continue to discuss the outcome, the exposure will remain, we shall keep on picking the infection from the source. Where is the source of this infection,” he told the second joint district task force meeting.

Hon. William Andeoye, Nyadri Sub-county Chairperson said the sub-county leaders should be involved in contract tracing after it was revealed that some of the people who turn-out positive for TB can’t be located.

“The health units should give us the lower local governments reports of the people who are lost so that we find out where this person is because these people have the actual addresses in the register. You give us quarterly reports so that we follow up on the lost cases. We shall be together with VHTs, CHEWs to follow these people,” he proposed.

Mr. Vasco Atiku, head teacher Kololo Primary School, suggested a clear pathway on case referral from the schools to health facilities to enable quick follow-ups and concrete contact tracing among learners be established.

There is need for regular referrals. People don’t care about follow up of referrals, if I have made a referral to my nearby health facility who far has the issue reached , what is the necessary input required from me as the school administrator so that there is need to make follow-up. That follow-up will help me come up with a report that will be submitted to DEO’s Office,”  he said.

With the technical support of World Heath Organization (WHO) and Ministry of Health, the District has developed a TB response plan costed at Shs349 million.  

Dr. Chris Opene, a social anthropologist with WHO, said creening needs to ramped up with the current 65 percent rate below par.  

“There are 35 percent out there who are not tested some of these might multi-drug resistant TB, 2 percent of our cases multi-drug resistant and one case can affect  over100 people.”

He added: “Bring the traditional healers because they are point of care seeking, I was in DR-Congo one of the cases recently was from a traditional healer her body was wasted, she was 49kgd, now she is on medication, she is in 60s the traditional healers, religious leaders, politicians, you are the people our communities listen to. Wherever you deliver this very useful message and tell people the signs and symptoms”

Mr. Patrick Olila, Maracha District Chief Administrative Officer, said the Ministry of Health should work with district in this journey to address the situation.

Dr. Paul Onzubo, Maracha District Health Officer, warned schools against closing before the school calendar since the campaign will run for two week, “can we look for those accumulated cases of people with TB which are in the communities, because the vans are here”

He further explained: “We gave you the contextual factors most of which are with you, get those which are within you control.”

Sr. Jessica Draru, Maracha District Assistant District Health Officer-Maternal Child Health, said the high case detection among learning was a damning verdict on the BCG coverage in the district.  

“If this child is not vaccinated especially these ones of Primary one we task the health facilities to vaccinate these children. The children who have tested positive for Tb were they vaccinated, we also needed to track them. Our BCG coverage is very low. That is why all our children are exposed.”  She guided.

In Uganda, the BCG vaccine is administered at birth or at the first healthcare facility visit within the first six weeks of life. The vaccine is given primarily to protect against severe forms of tuberculosis.

During the first joint district taskforce meeting, Ms. Monica Koliba Koteevu, Maracha Deputy Resident District Commissioner (RDC) directed sub-counties to avail to the health department lists of TB hotspots for mapping and contract tracing.   She said porous border possess a challenge in addressing the TB surge. 

TB symptoms can vary, but often include a persistent cough lasting longer than three weeks, which may be accompanied by mucus or blood. Other common signs are fatigue, loss of appetite, weight loss, fever, and night sweats.