Advances in TB control - Solomon Islands

Tuesday, 4 June, 2013

Tuberculosis (TB) control is improving rapidly in a remote area of the Solomon Islands with high incidence of TB cases. Atoifi is addressing the serious East Kwaio TB problem with assistance from Australian organisations, including the Australian Respiratory Council.

The island of Malaita has the highest incidence of tuberculosis (TB) in the Solomon Islands, 115 cases / 100,000 people. TB control in the East Kwaio region has been poor owing to cultural differences making it difficult for some groups to access TB services (Massey et al 2012). However, the Atoifi Adventist Hospital (AAH) has responded and the situation is rapidly changing. Details are given in a paper just published in Rural and Remote Health (Massey et al 2013).

The improvements include:

  • Building a new TB Ward that is culturally safer: the new ward, designed to meet both socio-cultural and health requirements, is now under construction (see picture above).
  • Food for TB inpatients: AAH now purchases food each week for TB inpatients to enhance treatment. Currently other hospital inpatients provide their own food.
  • Active case finding and treatment: the AAH TB Team have conducted active case finding in distant TB hotspots including the Kwaibaita Valley and remote mountain hamlets. Ten new cases were found during community visits and treated, including one person treated only in the community setting.
  • Stronger links with the National TB Program: the Provincial TB Coordinator is involved in the TB DVD project and has invited AAH to run research-training workshops in the provincial capital.
  • Reported TB case numbers increased: Since the commencement of the research capacity-strengthening approach and concentration on TB, annual reported cases of TB at AAH have increased from four cases in 2009 to 34 cases in 2012, increasing the case detection rate.
  • Funded Project to develop TB resources: AAH was successful in applying for a grant from the Australian Respiratory Council to develop local TB resources. This project will work with the traditional oral story-telling model of education and communication, but with modern technology. Locally made videos in local language and Pijin are being developed for community based TB education, including taking DVD players and video clips into remote hamlets and villages to stimulate discussion.

The outcomes to date illustrate how an empowered local team of health professionals and chiefs, with some input from outside experts, can make a real difference to TB control (Massey et al 2013). Tropical Health Solutions are partnering with Atoifi Adventist Hospital, Atoifi College of Nursing, James Cook University and Hunter-New England NSW Health in this research capacity building venture.

Massey PD, Asugeni R, Wakageni,J, Kekeubata E, Maena’aadi J, Laete’esafi J, Waneagea J, Harrington H, Fangaria G, MacLaren D, Speare R. Progress towards TB control in East Kwaio, Solomon Islands. Rural and Remote Health 2013;13:2555.

Massey PD, Wakageni J, Kekeubata E, Maena’adi J, Laete’esafi J, Waneagea J, Fangaria G, Jimuru C, Houaimane M, Talana J, MacLaren D, Speare R. TB questions, East Kwaio answers: community-based participatory research in a remote area of Solomon Islands. Rural and Remote Health 2012;12:2139.

Image: New TB ward at Atoifi under construction - April 2013.

Posted by Rick Speare