From January to September 2009, 4,401 tuberculosis (TB) patients were treated in government health centres country-wide, according to just-released government figures. Deddeh Bah Kesselly, head of the government's TB control programme, said the final tally for 2009 is certain to be higher than the 5,000 cases brought forward in 2008.
Government and NGO awareness campaigns have taken place in the capital Monrovia and surrounding counties, encouraging sufferers to come forward for treatment, health workers said.
The government set up what they called "TB hubs" throughout the capital to encourage people with consistent coughing to be tested, according to Kesselly.
The International Committee of the Red Cross also recently completed a TB awareness programme in Monrovia's nine neighbourhoods, with the message: "TB is curable, treatment is free and you can return to your family once cured," project coordinator Solomon Addison told IRIN.
"In the past, not much was heard about TB unless [one] visited a hospital," Addison said. "But if people remain unaware that treatment works, the stigma [surrounding TB] stops people from coming forward."
Many Liberians associate TB with HIV/AIDS and think both diseases are incurable and automatically kill, said Kesselly, whose team conducted surveys of attitudes about TB prior to their campaign.
Addison said many TB sufferers are ostracized from their communities, losing friends, family support and in some cases their jobs.
Joseph Wah, 33, lives in Paynesville on the outskirts of Monrovia. "I have been tested [for TB]," he said. "I do not have the disease - I was lucky. Many people here are stigmatized when they find out they have TB, which can cause them serious problems in their lives."
It is not only fear but false assumptions about the illness that prevent people from seeking treatment, said Addison.
John Doh, also from Paynesville, has had a consistent cough for several months. He told IRIN: "I have heard about TB but I have not been tested yet. I feel this is a curse from the sea spirit. If I am not a member of the marine spirit society, then I will not be affected by it."
Beyond the capital
The government and NGOs have made progress in the capital but stigma is high in other areas of Liberia and so testing rates there are low, Addison told IRIN.
"We are still seeing very low caseloads in smaller towns, which we do not think necessarily reflects the [real number of infections]. We need to expand our treatment and our [education campaigns] there." He said too few people know about existing testing and treatment facilities.
Treatment in small towns and villages has significantly improved since 2008, according to the national TB programme's Kesselly. Case detection rates have improved and some 236 health clinics across the country now have TB treatment facilities, while 25 laboratories are able to test the disease. The TB control project is supported by the Global Fund to fight AIDS, Tuberculosis and Malaria.
In 2009 the Global Fund provided the control programme with vehicles so drugs could be delivered more quickly to rural clinics, while the UN Development Programme helped the health authorities devise more efficient drug supply-chain systems, Kesselly said.