At this clinic, staff is tackling a thorny issue — the difficulty of diagnosing TB among people living with HIV. TB diagnosis is said to require visualization under a microscope of the bacteria that cause the disease, obtained via sputum samples.
Among people living with HIV, often few bacteria are present in the sputum and they are therefore not detectable through conventional diagnosis, even if the person has serious TB disease. Consequently the diagnosis is often missed, staff said.
Patients who enroll at this health centre with tuberculosis are also tested for HIV and those found to be HIV positive are given integrated care and support.
For said Dr Jorge Sampaio, the UN Secretary-General's Special Envoy to Stop TB: “It is a programme that reflects Rwanda's impressive progress nationwide on coordinating TB and HIV services”.
"It is gratifying to be at this clinic, which has intensified TB case finding in people living with HIV through TB screening and transferring confirmed cases to a TB clinic”, he said after the tour.
This can only be achieved by, according to UNAIDS Executive Director Michel Sidibé, by ‘bold leadership’.
“I am pleased to see that Rwanda is leading Africa and the world in taking an integrated approach to dealing with the interlinked epidemics of TB and HIV. Rwanda’s bold leadership is achieving impressive results that show the rest of Africa what can be achieved," said Mr Sidibé said.
The two envoys proceeded to another joint visit to Rwanda's National Reference Laboratory in Kigali, where they saw evidence of the country's major investment in laboratory services.
The sensitivity of a TB diagnosis can be improved by incubating the samples to multiply the TB bacteria; but this process can take weeks or even months using conventional methods. To increase speed and accuracy of TB diagnosis, fast liquid culture (MGIT) will be introduced and rolled out soon in Rwanda, the envoys said.
The National Reference Laboratory is also studying more efficient microscopes and staining techniques to improve speed of TB diagnosis.
Since 2004 Rwanda has had the capacity to test for drug-resistant TB. The National Reference Laboratory and the other main laboratories in the country are also currently developing their capacity to diagnose cases of XDR-TB – although none have been detected in Rwanda to date.