Tuberculosis (TB) remains a public health concern been an ongoing burden for the National Referral Hospital (NRH). Hospital statistics indicate that at least three newly diagnosed cases of TB are admitted to the TB isolation ward through the Outpatient Department (OPD) of the Emergency Department each month.
IMPACT ON HOSPITAL RESOURCES
Although TB is primarily a community and public health issue, it has significant operational impacts on NRH. TB patients require more hospital resources, longer bed occupancy, increased staff time, and multidrug treatment regimens.
At one point, the OPD had 13 highly infectious TB patients waiting for beds in the TB ward. In 2025, NRH recorded 16,408 admissions out of 112,706 patients who sought medical care at the hospital. Of these admissions, 158 patients were admitted to the TB ward, representing approximately 2% of total admissions.
LENGTH OF STAY AND BED PRESSURE
TB patients draw heavily on hospital resources because they generally stay longer than most other patient groups and require daily combination treatment against TB infection. Their average length of stay is 43.2 days, compared with the overall NRH average of about 6.43 days. This means TB patients remain in hospital several days longer than the average patient and longer than other long-stay groups, including diabetic and orthopaedic patients.
This extended length of stay contributes to bed shortages, with increasing numbers of TB patients waiting in the OPD for admission to the TB ward.
ROLE OF THE NEW TB HOSPITAL WING
The upcoming TB hospital wing is expected to ease pressure on bed space, but it will not eliminate TB transmission in the community on its own. Reducing TB infection will require a multisectoral approach, supported by individuals, families, communities, and health partners. Early screening and treatment-seeking behaviour will be essential.
The new wing will provide approximately 30 beds for patients requiring extended care.
It will include nine isolation beds for acute, newly diagnosed, and multidrug-resistant TB cases.
It will support the development of expertise in critical patient care, TB research, and management of multidrug-resistant tuberculosis,
MHMS TB DIVISION: ACTIONS TO MANAGE TUBERCULOSIS (TB) CASES
The MHMS TB Division is strengthening TB prevention, detection, treatment, and program management through the following key actions:
Primary Health Care & Outreach: Integrating TB services into primary health care, expanding case finding through contact tracing and hotspot screening, increasing TB preventive treatment, and strengthening community-based care.
Workforce Development: Recruiting a TB Advocacy Officer and training clinicians, nurses, and TB coordinators on TB program management and clinical care.
Medicines & Supplies: Ensuring uninterrupted availability of TB medicines through improved forecasting, quantification (using QuanTB), and stock management.
Diagnostics: Expanding access to GeneXpert testing nationwide, with all provinces covered and additional expansion planned for Central Islands Province (CIP), Rennell and Bellona (RenBel), and Guadalcanal Province (GP).
Data Systems: Strengthening TB surveillance through DHIS2, with training completed and reporting now implemented across all provinces.
Coordination & Governance: Improving technical oversight, partner coordination, provincial engagement, and community participation through a functioning bi-monthly TB Technical Working Group.
Public Health Initiatives
TB Detection
Contact tracing is underway / planned in all provinces.
Active case finding is being conducted in hotspot areas and correctional facilities, including recent activities in Guadalcanal Province, Honiara City Council, and Malaita Province.
TB Treatment
Supportive supervision and training have been provided to strengthen patient management, including training for TB focal nurses, nurses, and clinicians in Honiara City Council and the National Referral Hospital.
Updated National TB Treatment Guidelines have been launched and are awaiting nationwide dissemination through training.
TB Prevention
TB preventive treatment has been rolled out in Honiara City Council, Malaita, and Guadalcanal.
A National TB Communication Strategy has been developed and is awaiting endorsement.
Public awareness activities are ongoing through radio campaigns and the development of information, education, and communication (IEC) materials.
