Tuberculosis rate alarmingly high

Tuberculosis is a significant public health problem for both industrialised and developing countries. The WHO has indicated that one-third of the world's population is infected by TB. Pakistan is currently listed among the six countries where the problem of tuberculosis is alarmingly high, said Director TB Control Programme Sindh Dr Iqtidar Ahmad here on June 19.
He stated that generally women view the deadly disease of tuberculosis (TB), affecting 250,000 people every year in Pakistan, differently from men. While men believe TB was curable, women regarded it as an incurable affliction.
Women in their reproductive years are more likely to develop the disease than men in the same age group. He informed that 750,000 women died in 1998 across the globe due to problems related to TB.
Dr Iqtidar said the disease killed more women than those who died in all the cases of maternal mortality combined. He said that according to a recent survey, knowledge regarding tuberculosis is deficient in both males and females but, interestingly, it is revealed that the knowledge of rural people about TB is slightly better than the people living in urban areas.
He informed that people in urban areas mostly go to private hospitals or quacks in slum areas that have little knowledge about TB. While in rural areas people visit the government or public hospitals where government programmes like DOTS (Directly Observed Treatment Strategies) are effectively being implemented.
He said the role of print media, television and radio is negligible in imparting knowledge on TB and doctors also have not been spreading knowledge about TB in urban areas.
He said that DOTS was implemented late in Pakistan. However, in the last three years it had gained momentum and now a large segment of the population was benefiting from the scheme.
He said that in Sindh the ratio of DOTS coverage is nearly 70 per cent. In the entire country it is 40 per cent, which signifies a major development. Up to 30,000 have new untreatable form of TB.
A new, untreatable form of tuberculosis is striking up to 30,000 people a year, the World Health Organisation said on Friday, and warned it could spark an "apocalyptic scenario" if unchecked.
The United Nations agency appealed for $2.15 billion to combat drug-resistant TB under a programme which it said could save up to 134,000 lives over two years. Extensively drug resistant TB (XDR-TB), a form virtually immune to antibiotics, has been reported in 37 countries in all regions since emerging in 2006, according to the WHO.
"There is somewhere between 25,000 and 30,000, we roughly estimate, cases of extensive drug resistant TB each year," Paul Nunn, co-ordinator of WHO's Stop TB Department, told a briefing.
"Ultimately, to face down this epidemic, we need new tools - we need new drugs, we need new diagnostics," he added.
The recent case of an American man with XDR-TB who travelled abroad triggered an international health scare, highlighting the potential risks of rapid spread.
XDR-TB cases are particularly difficult to treat, and a patient could infect other people for years, according to Mario Raviglione, director of the WHO's Stop TB Department.
"That is the big threat here. If you have more and more of these cases, you will automatically magnify the problem by having transmission going on to other individuals. Once they become infected they are sort of a time bomb," Raviglione said.
"If this is kept unchecked and goes on, then you may also see an apocalyptic scenario where the present epidemic of TB is replaced by an epidemic of TB, which is now fully resistant to everything," he added.
"PRE-ANTIBIOTIC ERA":
Some 8.8 million people each year develop normal TB, a bacterial infection that usually attacks the lungs and which kills 1.6 million people a year, according to the WHO.
About 450,000 get a multi-resistant form (MDR-TB) each year which is resists the main first-line drugs, but XDR-TB occurs when there is resistance to even second-line drugs.
"The possibility is that you could replace that epidemic with a drug-resistant epidemic, in other words you could have 8 million cases of drug-resistant TB wandering around. And then you will be back to the pre-antibiotic era," said Nunn.
An outbreak in KwaZulu-Natal province of South Africa last year confirmed the WHO's fears about XDR-TB, which killed 52 of the 53 patients, mainly carriers of the HIV virus, he said.
"We really now have to focus on problems of infection control. We can't allow drug-resistant MDR or XDR to get into populations of HIV-infected people," he added.