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Tackling tuberculosis in Kiribati

Issue: Health

Country: Kiribati

As part of the Directly Observed Treatment Strategy (DOTS) in Kiribati, specialist nurses travel to supervise the treatment of tuberculosis.

Identity and cultural diversity, Social justice and human rights

Community health workers dispense medicines and check patients discharged from a hospital tuberculosis ward in Kiribati.

Community health workers dispense medicines and check patients discharged from a hospital tuberculosis ward in Kiribati. Photo by Lorrie Graham for AusAID

Tuberculosis

Tuberculosis, or TB, is an infectious, respiratory, bacterial disease, which most commonly affects the lungs. It is transmitted from person to person through the air. It can remain dormant in people’s lungs causing no symptoms, as the immune system acts to ‘wall off’ the bacteria. The symptoms of tuberculosis are coughing, chest pains, weakness, weight loss, fever and night sweats. One of the best ways to treat tuberculosis is with a six-month course of antibiotics administered through the Directly Observed Treatment Strategy (DOTS) in which health workers directly observe sufferers taking their medication. This ensures that it is taken regularly and correctly in an effort to control and reduce the incidence of tuberculosis and drug-resistant forms of the disease.

Tuberculosis is directly linked to overcrowded households. In the densely settled South Tarawa in Kiribati, poor housing conditions and an average of 11 people living in each house have led to the highest incidence of tuberculosis in the Pacific.

DOTS

The DOTS is part of the Quality Tuberculosis Epidemic Control Project run by the Secretariat of the Pacific Community and funded by the Australian Government. Maima Tawaia is one of the 15 community DOTS workers who use motorbikes to travel up and down South Tarawa to deliver medicines and make sure tuberculosis sufferers are recovering well and taking the right medicine. The team also includes four specialist nurses who travel the country identifying tuberculosis cases and raising awareness.

In Kiribati the maneaba is constructed to provide plenty of ventilation. This is where patients will convalesce for many months. The DOTS is proving successful as infectious cases are removed from overcrowded households. Patients are treated in isolation in hospital for up to two months after which the majority (95%) are no longer infectious. From hospital, patients are transferred to a special centre set up in a traditional building called a maneaba. Because the building is designed to allow air to flow through and there’s lots of space, it’s ideal for patients’ recovery without contributing to the spread of the disease.

Reducing tuberculosis

There has been a significant reduction in the incidence of the disease, from 745 new cases reported nationally in 2007 to 294 in 2010.

Coordinator Dr Takeieta Kienene said the program was working well.

I believe the Quality TB Epidemic Control Project is doing all it can in terms of systems strengthening by boosting ward space, improving laboratories and transport, and capacity development. I must say we have done a tremendous job in addressing the tuberculosis problem in Kiribati.

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In Kiribati the maneaba is constructed to provide plenty of ventilation. This is where patients will convalesce for many months.
Photo by Naomi T/Flickr, http://creativecommons.org/licenses/by-nc-nd/2.0/
Print | Save
In Kiribati the maneaba is constructed to provide plenty of ventilation. This is where patients will convalesce for many months. Photo by Naomi T/Flickr, http://creativecommons.org/licenses/by-nc-nd/2.0/
Community health workers dispense medicines and check patients discharged from a hospital tuberculosis ward in Kiribati.
Photo by Lorrie Graham for AusAID
Print | Save
Community health workers dispense medicines and check patients discharged from a hospital tuberculosis ward in Kiribati. Photo by Lorrie Graham for AusAID