Marshall Islands Launches Mass Tuberculosis Screening Program

RMI has the highest rate of TB in the Pacific, among the highest in the world

By Giff Johnson

MAJURO, Marshall Islands (Marianas Variety, Nov. 11, 2016) – A mass TB screening program that could have global ramifications for TB control was launched last week in the Marshall Islands.

The beginning of the first phase made good progress, with an estimated 2,000 of Ebeye’s 10,000 population seen by Ministry of Health staff, said Minister Kalani Kaneko.

The screening program for Ebeye Island is the first big initiative for lowering the high rate of tuberculosis in the Marshall Islands. In 2014, Marshall Islands reported a TB prevalence rate of 466 per 100,000 population, the highest in the Pacific and one of the highest in the world.

Ebeye and Majuro, the two urban centers in the Marshall Islands, have been identified by the U.S. Centers for Disease Control as two of three “TB hotspots” in the U.S.-affiliated Pacific island region. The other is Chuuk in the Federated States of Micronesia.

The first phase involves fingerprinting pre-registration of all residents, weight check ups, and nutrition counseling for mothers with babies or children identified as malnourished. The fingerprinting is an initial step by the Ministry of Health to digitize records to improve tracking and management of patients. Health workers are also taking the opportunity of the TB screening to incorporate non-communicable disease prevention for diabetes.

The second phase starts in February with the actual TB screening and treatment. The program is supported by the World Health Organization and CDC.

The Ministry of health “was able to reach over 20 percent of the population on Ebeye, and if we can sustain this momentum, we should be able to reach our phase one target” by early December, said Glorine Jeadrik, the Assistant Secretary of Health for Ebeye, earlier this week.

She and Kaneko confirmed that the U.S. government has just approved $244,000 from funding under the Compact of Free Association to support the phase two screening.

“Since the 1970s, the WHO and CDC have not done mass screenings,” said Kaneko. “If the Ebeye program is successful, it could be done elsewhere. Other countries with similar problems can benefit from what we are doing.” Kaneko added that after the Ebeye screening is done, the ministry and these international health agencies will turn their attention to Majuro.

“We won’t stop TB with this screening,” said Dr. Richard Brostrom, the TB Medical Officer for the Pacific Region, Branch Chief of the Hawaii TB Program for CDC. “But the aim is to decrease the level by 30 percent of more.”

Brostrom said that “there has been measured, modest success” in the TB situation in U.S.-affiliated islands. “The TB rate has dropped 20 percent over the last 15 years in U.S.-affiliated Pacific islands,” he said. “This success is tempered by tremendously high rates — ‘rates’ that mean illness and deaths.” TB is still a “devastating” problem for the Pacific islands, he added.

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