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The majority of Malagasy people live in rural areas. Their survival depends on food crops. The crops, unfortunately are inadequate compared to the work load of the Malagasy people. This work is very difficult due to inadequate and inappropriate materials .

Consequently, Malagasy people,especially in rural areas, are physically weak and don’t have sufficient antibodies to struggle against diseases, especially TB. It is common to see four to six persons residing in the same room with inadequate ventilation. If one person contracts TB, the whole family possibly could be affected by this disease.

Since 1986, SALFA has implemented a structure which fights against tuberculosis. One physician for each health center is trained to take care of the TB patients and he is helped by one, two, three or four TB scouts who are the health workers who work closely with the TB patients. The physician sets up the treatment; the TB scout is responsible for sensitization of the patients and their families. He also distributes the medications (directly observed therapy or DOT) which means that the patients swallow the anti-TB drugs in the presence of the TB scout each day over a two to eight month period, depending upon the TB treatment model. The TB scout searches for defaulters, bicycling to rural villages within a radius of 50 to 100 kilometers.

NOTE: 8 km = 5 miles.
  1. To detect 70% of TB cases in the community
  2. To cure 85% of Pulmonary TB cases with positive bacilloscopy
  3. To have less than 10% defaulters.

STRATEGY


DOTS
  1. Political commitment with increased and sustained financing
  2. Case detection through quality-assured bacteriology
  3. Standardized treatment, with supervision and patient support
  4. Effective drug supply and management system
  5. Monitoring and evaluation system
  6. Impact measurement

Beginning in 1986, the TB project was helped by friends from the USA. At that time, Dr N’Kinda from CBM consented to finance a great part of SALFA's TB activities. In 1993, Tone Ringdal, member of the UICTMR, helped SALFA to apply for a large project to fight against TB. This application was sent to NORAD. The project with NORAD started in 1995 and ended in 2006.

OUR RESULTS

More than 3000 TB patients are treated every year at 32 SALFA centers. Six mobile teams are working in rural areas and are collaborating
with the government health centers.

  • Cure rate: 80%
  • Case detection: 70%
  • Defaulter rate: 5%

At the present time, the SALFA/TB program is seeking new financing due to the delay of the allocations in the quarterly budgets. SALFA contributes to one-fourth of TB treatment results throughout Madagascar