Burma Must Tackle TB and HIV
By Marwaan Macan-Markar, Inter Press Service News Agency (IPS), 5 September 2005
BANGKOK (IPS) - For over 15 years a clinic in Mae Sot, a town along Thailand's north-western border, has offered a glimpse into how widespread tuberculosis (TB) is in neighbouring Burma.
It is to that clinic, run by Dr.Cynthia Maung, that a stream of poor men, women and children, escaping military-ruled Burma for Thailand, come to for a health check. "In 2004 we detected 700 cases of TB, of which 250 needed treatment," said Maung, herself a refugee who fled Burma in 1988 following Rangoon's harsh crackdown on a pro-democracy movement.
TB remains one of the major diseases that the hundreds crossing over from Burma suffer from, she explained during a telephone interview from her clinic in Mae Sot. "We are concerned because every year the cases are high".
Similar conclusions have been reached by officials at Thailand's ministry of public health, given the number of TB cases that have been detected during mandatory health tests done to the thousands of migrants from Burma who seek legal employment in this country.
In 2003, for instance, there were 1,766 Burmese with TB who required follow-up treatment, states a health ministry study. The infection that followed TB was syphilis, with 952 cases.
In 2002, in the Tak province alone, where Mae Sot is located, Thai health officials had required 885 Burmese to commence medical treatment for TB. That was out of an estimated 30,000 migrant workers who were seeking jobs in the large agriculture farms and the many garment factories there.
The number of migrant workers with TB has added to the incidence rate of this killer disease in Thailand, compelling Bangkok to step up TB detection and treatment efforts. "This year we put TB among one of the priority problems we have to tackle," Dr. Kamnuan Ungchasuk, director of the bureau of epidemiology at the health ministry, told IPS.
These numbers, however, are dwarfed by reports that Burma has 97,000 new cases of TB ever year and this South-east Asian nation is classified by the World Health Organisation (WHO) as being among the world's 22 'high burden'countries with the disease.
More troubling for public health experts is the high prevalence of multi-drug resistant TB (MDRTB) in Burma. It has four percent new cases of MDRTB, states the Geneva-based health body.
The frequency of MDRTB, which is incurable since it does not respond to available cheap anti-TB drugs, has placed Burma on the top of the list of afflicted countries in the region.
According to the WHO, Thailand has 0.9 percent of the new cases of MDRTB, Bangladesh has 1.4 percent new cases and even India, the country with the greatest TB burden, there are only 3.4 percent new MDRTB cases annually.
The only country in East Asia worse off than Burma for new MDRTB cases is China, with a reported 5.3 percent prevalence rate.
"The situation in Myanmar is a concern because four percent new cases in a high burden country is no trivial number of patients - several thousands, likely between 4,000-6,000 cases," a WHO official told IPS.
Such revelations about Burma, whose military rulers changed the country's name to Myanmar, come at a time when there is a global effort to rid the world of this pandemic, which kills nearly two million men, women and children every year.
As part of the Millennium Development Goals (MDGs), world leaders pledged at a U.N. summit in New York in 2000 to stop the spread of the world's leading killer diseases - AIDS, TB and malaria - by 2015.
Other MDGs to be achieved by that year include halving the number of those living on less than one US dollar a day, ensuring universal primary education for all boys and girls, reducing by two-thirds the number of children who die before reaching five years of age and reducing by three-fourths the number of women who die while giving birth.
And the WHO makes the alarming prediction of what the world will be faced with if TB, a curable infectious disease, is not overcome. In the next 20 years, almost one billion people will become newly infected, 200 million people will develop the disease and 35 million will die from it, it states.
It is a scenario made worse by the ease with which TB feeds off the other global pandemic, AIDS, which killed 3.1 million people last year. "TB is the leading killer of people infected with HIV," states the WHO, due to the weak immune systems of those with the virus that causes AIDS.
Currently, some 14 million people are co-infected with TB and HIV, of which 70 percent are in Africa.
The likelihood of Burma adding to those numbers has grown in the light of the fact that the country has the second highest prevalence rate of HIV in South-east Asia with an estimated
170,000 to 620,000 people living with the killer disease, according to a U.N. agency.
And a decision by an international funding agency to pull out of Burma in August due to roadblocks imposed by the military regime -- consequently hampering its 98.4 million-dollar contributions for programmes to combat AIDS, TB and malaria - has set off more alarm bells.
Yet, the WHO feels that such concern, at least over TB, may be misplaced, since the junta has implemented a range of public health initiatives despite its limited resources and a weak health system.
"For a resource-constrained country, Myanmar has a well functioning TB programme and a very good laboratory, which should enable the country to address the problem of MDRTB," says the WHO official.
"Political commitment to DOTS is high in Myanmar," added the official, referring to the Directly Observed Treatment Short Course strategy of diagnosing and ensuring administration of cheap anti-TB drugs to patients.
"DOTS coverage is 100 percent, meaning that all of the 324 townships have a DOTS clinic, although access to services varies widely."
Online at: http://www.ipsnews.net/news.asp?idnews=30136
Source: SEA-AIDS eForum
BANGKOK (IPS) - For over 15 years a clinic in Mae Sot, a town along Thailand's north-western border, has offered a glimpse into how widespread tuberculosis (TB) is in neighbouring Burma.
It is to that clinic, run by Dr.Cynthia Maung, that a stream of poor men, women and children, escaping military-ruled Burma for Thailand, come to for a health check. "In 2004 we detected 700 cases of TB, of which 250 needed treatment," said Maung, herself a refugee who fled Burma in 1988 following Rangoon's harsh crackdown on a pro-democracy movement.
TB remains one of the major diseases that the hundreds crossing over from Burma suffer from, she explained during a telephone interview from her clinic in Mae Sot. "We are concerned because every year the cases are high".
Similar conclusions have been reached by officials at Thailand's ministry of public health, given the number of TB cases that have been detected during mandatory health tests done to the thousands of migrants from Burma who seek legal employment in this country.
In 2003, for instance, there were 1,766 Burmese with TB who required follow-up treatment, states a health ministry study. The infection that followed TB was syphilis, with 952 cases.
In 2002, in the Tak province alone, where Mae Sot is located, Thai health officials had required 885 Burmese to commence medical treatment for TB. That was out of an estimated 30,000 migrant workers who were seeking jobs in the large agriculture farms and the many garment factories there.
The number of migrant workers with TB has added to the incidence rate of this killer disease in Thailand, compelling Bangkok to step up TB detection and treatment efforts. "This year we put TB among one of the priority problems we have to tackle," Dr. Kamnuan Ungchasuk, director of the bureau of epidemiology at the health ministry, told IPS.
These numbers, however, are dwarfed by reports that Burma has 97,000 new cases of TB ever year and this South-east Asian nation is classified by the World Health Organisation (WHO) as being among the world's 22 'high burden'countries with the disease.
More troubling for public health experts is the high prevalence of multi-drug resistant TB (MDRTB) in Burma. It has four percent new cases of MDRTB, states the Geneva-based health body.
The frequency of MDRTB, which is incurable since it does not respond to available cheap anti-TB drugs, has placed Burma on the top of the list of afflicted countries in the region.
According to the WHO, Thailand has 0.9 percent of the new cases of MDRTB, Bangladesh has 1.4 percent new cases and even India, the country with the greatest TB burden, there are only 3.4 percent new MDRTB cases annually.
The only country in East Asia worse off than Burma for new MDRTB cases is China, with a reported 5.3 percent prevalence rate.
"The situation in Myanmar is a concern because four percent new cases in a high burden country is no trivial number of patients - several thousands, likely between 4,000-6,000 cases," a WHO official told IPS.
Such revelations about Burma, whose military rulers changed the country's name to Myanmar, come at a time when there is a global effort to rid the world of this pandemic, which kills nearly two million men, women and children every year.
As part of the Millennium Development Goals (MDGs), world leaders pledged at a U.N. summit in New York in 2000 to stop the spread of the world's leading killer diseases - AIDS, TB and malaria - by 2015.
Other MDGs to be achieved by that year include halving the number of those living on less than one US dollar a day, ensuring universal primary education for all boys and girls, reducing by two-thirds the number of children who die before reaching five years of age and reducing by three-fourths the number of women who die while giving birth.
And the WHO makes the alarming prediction of what the world will be faced with if TB, a curable infectious disease, is not overcome. In the next 20 years, almost one billion people will become newly infected, 200 million people will develop the disease and 35 million will die from it, it states.
It is a scenario made worse by the ease with which TB feeds off the other global pandemic, AIDS, which killed 3.1 million people last year. "TB is the leading killer of people infected with HIV," states the WHO, due to the weak immune systems of those with the virus that causes AIDS.
Currently, some 14 million people are co-infected with TB and HIV, of which 70 percent are in Africa.
The likelihood of Burma adding to those numbers has grown in the light of the fact that the country has the second highest prevalence rate of HIV in South-east Asia with an estimated
170,000 to 620,000 people living with the killer disease, according to a U.N. agency.
And a decision by an international funding agency to pull out of Burma in August due to roadblocks imposed by the military regime -- consequently hampering its 98.4 million-dollar contributions for programmes to combat AIDS, TB and malaria - has set off more alarm bells.
Yet, the WHO feels that such concern, at least over TB, may be misplaced, since the junta has implemented a range of public health initiatives despite its limited resources and a weak health system.
"For a resource-constrained country, Myanmar has a well functioning TB programme and a very good laboratory, which should enable the country to address the problem of MDRTB," says the WHO official.
"Political commitment to DOTS is high in Myanmar," added the official, referring to the Directly Observed Treatment Short Course strategy of diagnosing and ensuring administration of cheap anti-TB drugs to patients.
"DOTS coverage is 100 percent, meaning that all of the 324 townships have a DOTS clinic, although access to services varies widely."
Online at: http://www.ipsnews.net/news.asp?idnews=30136
Source: SEA-AIDS eForum
posted by AIDS-Care-Watch at 9:57 pm
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