26,000 people to be screened in Majuro for TB, leprosy

Majuro Mayor Ladie Jack, left, and Health Minister Kalani Kaneko were among the first to participate in the mass TB and leprosy screening program launched in Majuro last week. Picture: Kelly Lorennij

MAJURO, 18 JUNE 2018 (MARIANAS VARIETY) — After 14 months of planning, the Ministry of Health in the Marshall Islands launched last week a programme to screen 26,000 people in Majuro for tuberculosis and leprosy or Hansen’s Disease. Initial results showed a high turnout for the screening and treatment program.

The mass screening follows a similar programme successfully conducted last year on Ebeye Island, the second large urban area in the nation. Health officials reported that last year’s intervention cut the number of TB infections among Ebeye residents by 50 percent.

Over 1,400 people were screened in the first week of the programme, said a health official Saturday.

Health officials say that at least one-in-four Majuro residents are positive for TB — most with “latent” TB, meaning they are not sick or experiencing symptoms, but are at risk of getting the illness later in life.

“Our Hawaii data — recent testing for over 3,000 Marshallese who were tested for TB in Hawaii — indicates that 28 percent of the population is TB skin test positive,” said Dr. Richard Brostrom, a TB expert from the U.S. Centers for Disease Control, who is in Majuro working with local health officials. “The actual rate in the general population in Majuro is unknown, but is likely close to that number.”

Health officials estimate that over 7,000 people in Majuro out of a population of 28,000 have latent TB and are at high risk of getting sick with tuberculosis in the future. CDC and World Health Organisation officials are supporting the screening and treatment in Majuro with funding, technical assistance, supplies and volunteer medical staff.

“There are too many cases of TB in the Marshall Islands, and we can do something about that,” Brostrom said at Monday’s launch, which included a parade with floats, speeches, music, and top government leaders lining up to be the first to be screened, including parliament Speaker Kenneth Kedi, Health Minister Kalani Kaneko and Majuro Mayor Ladie Jack.

Brostrom made the point that “this is not a surveillance project. Working with the hospital and public health staff, we are not here to count, we are here to cure.”

By Friday’s wrap up of the first week of operations, the Ministry of Health was operating two screening locations at elementary schools in the heavily populated downtown area, busing residents to the screening centers. No statistics were available for the first week, but the first full day of screening at the Rita Elementary School screening location saw 180 people come for testing — above the ministry’s target for screening 150 people a day.

The Marshall Islands ranks in the top 10 countries with the highest prevalence of TB, and is in the top three globally for leprosy. In 2013, the RMI was the second most TB-affected country — this year it is number 11, according to health officials, indicating last year’s treatment programme at Ebeye significantly reduced the problem.

The biggest challenge to successful screening, based on the experience last year on Ebeye, is getting men to come forward to be screened.

“In Ebeye, we struggled getting the men to come and be screened,” said Brostrom. “This is pretty typical. Around the world, men typically do not place a high priority on preventive healthcare.”

The Majuro screening and treatment programme is scheduled to continue into September, with the goal of seeing 150 people daily.

The health organisations are providing free medication for those who test positive.