In 2011 alone, 8.7 million people fell ill with tuberculosis (TB) and 1.4 million died with 95 per cent of these deaths occurring in low and middle-income countries. Every day 4000 people lose their lives to TB, three persons every minute. TB killed 6,400 children in 2011. These numbers make tuberculosis the second top killer of adults worldwide.
According to estimates, one-third of the world’s population is infected with TB. Someone in the world is newly infected with TB bacilli every second. TB that emerged as a serious health threat is on the rise in developing countries like Pakistan, affecting the health of thousands of people. Pakistan is not on the track to meet the Millennium Development Goal of halving deaths from TB between 1990 and 2015, said Head of Department of Community Medicine at CMH Lahore Medical College, Professor Dr Muhammad Ashraf Chaudhry, while talking to ‘The News’ in connection with the World TB Day.
He believes that every year, thousands of people die of a disease, which is completely preventable and 100 per cent curable. Our country has currently annual death rate of 38 per 100,000 people attributed to tuberculosis. A large number of people, though infected with the TB bacilli, do not get diagnosed, either because of poverty, or lack of awareness about the seriousness of the disease, he said.
He added that left untreated, one person with active TB may infect 10 to 15 people during one year. The delay in diagnosis, unsupervised, inappropriate and inadequate drug regimens, poor follow up and lack of social support programme for high risk populations are some of the reasons for not reaching the target cure rates and emergence of drug resistant forms of tuberculosis, he said and added that multi-drug resistant TB (MDR-TB) is the upcoming threat for TB control.
Dr. Ashraf said that contacts of infectious TB patients are at high risk to develop TB. “When infectious TB patients cough, sneeze, talk, spit, they propel TB germs into the air. When healthy persons inhale the air, they become infected. TB is not spread through casual contact, utensils, eating together, shaking hands, sharing clothes, bed sheets, books, furniture, marital relations and it is not an inherited disease.”
He said that the main symptoms of disease are persistent cough for more than three weeks, low-grade fever, evening pyrexia, coughing up blood, night sweats, loss of appetite, loss of weight and feeling of tiredness all the time. “If somebody has these symptoms, he/she should report to the nearest health centre, government hospital or TB centre and get his sputum tested free of cost. If somebody is diagnosed with TB, he/she should not get upset, because TB is now treatable. TB should be cured in order to stop TB,” he said.
Dr. Ashraf added that patient should take anti-TB drugs as advised by the doctor under the supervision of health worker or some responsible person for eight months without interruption. “Never leave treatment without advice of doctor,” he said.
To a query, he said that during anti-TB treatment, a mother can breastfeed her child. Stigma associated with TB that it was a death sentence was often a false impression. Patients should not be stigmatised and must receive full support from family and community, he said and added that a TB patient can lead an active normal life after receiving full course of treatment. “However, current default rate in Pakistani TB patients is still 11%, which leads to multi-drug resistant TB (MDR-TB) and in some cases extensively drug-resistant TB (XDR-TB), which is the most dangerous form of TB with no treatment.
Remember! Complete TB treatment is the most effective means of TB prevention.” He added that TB can be prevented by BCG vaccination and by awareness raising campaigns on mass scale. TB patient should be advised to cover his mouth while sneezing or coughing and not spit on different spots. Newborn infants must be immunised against TB with BCG vaccine immediately after birth. Celebrating of World TB Days also plays part in creating awareness about the disease among general masses, he said.