Scourge of TB rears its ugly head
By, The Nation, May 25, 2007
Public health campaign needed to educate the public on tuberculosis and to combat rise of drug-resistant strains
A resurgence of tuberculosis (TB), which was declared a global public health emergency more than a decade ago, has focussed the world's attention on the need to redouble efforts to try to contain the spread of this deadly disease. Thailand, which had been so successful in combating TB in the past, has contributed to the widespread misconception that the disease has already been beaten.
The disease, however, has come back with a vengeance in recent years mostly in developing countries, including Thailand. Public health experts have expressed concern about the emergence of drug-resistant strains of the disease and the Aids pandemic, which, they say, could combine to bring death and suffering to millions of people worldwide.
Thailand was caught by surprise when the World Health Organisation ranked the country 17th out of 22 countries in the world with the highest rates of TB infection. According to a Public Health Ministry estimate, the TB rate in densely populated areas like Bangkok could be as high as one in every 500 people.
Most infected people are not aware of the disease, which is caused by the Mycobacterium tuberculosis bacillus and can be spread through the air like the common cold. According to the WHO, if left untreated, one person with infectious TB will pass it on to an average of 12 to 20 people, and that two to four of these will develop infectious TB.
According to the WHO, even though the global TB rate may have stabilised over the past few years due to greater awareness among public health officials and control efforts, the actual number of people with TB has increased markedly as a result of an increase in the world's population. The world health body said there were about 8.8 million new TB cases and 1.6 million deaths due to the disease in 2005.
Thailand is a classic example of how a high rate of HIV/Aids infection can fuel a TB resurgence. It has taken Thai health authorities years to shed complacency and wake up to the threat posed by the HIV/Aids-TB combination to the country's public health system.
A recently released study by Dr Amara Soonthordhada entitled "TB Policy in Thailand: A Civil Society Perspective" exposes a striking lack of social and political commitment to control tuberculosis, one of the leading causes of death in Thailand.
Due to the absence of TB awareness among members of the Thai public, there is little understanding of how TB is spread and the fact that it can be cured. According to the study, many patients do not seek treatment because of the social stigma attached to the disease, a lack of information, and the high costs of the cure.
The emergence of drug-resistant strains of TB is a great possibility in Thailand where too many people have developed the habit of self-medicating by buying medicines, like antibiotics, from local pharmacies - many of which are not staffed by qualified pharmacists - and then not bothering to complete the whole course.
Health authorities are just now beginning to encourage people with TB to come forward to seek free treatment. TB can be cured with a treatment regimen that typically takes six months to complete. The most important thing is to ensure that patients take the right dose of medicine and complete the whole course to prevent strains of TB becoming drug resistant.
The Public Health Ministry's statistics shows that while TB rates fell by 50 per cent from 1985 to 1991, the HIV/Aids epidemic may have contributed to a resurgence of TB, which kills about 12,000 people a year in this country.
Public Health officials will find it difficult to identify people with TB. The standard, error-prone procedure for diagnosing tuberculosis was developed some 100 years ago and it involves putting sputum samples under a microscope and lab technicians identifying the bacteria that cause TB. That's why a public awareness campaign is very important to alert people of the looming public health threat.
For a country like Thailand where HIV/Aids and TB tend to combine with devastating effects, public health authorities must rationalise their work by merging HIV/Aids and TB treatment programmes in order to lower the death rate from TB, which is curable.
Public health campaign needed to educate the public on tuberculosis and to combat rise of drug-resistant strains
A resurgence of tuberculosis (TB), which was declared a global public health emergency more than a decade ago, has focussed the world's attention on the need to redouble efforts to try to contain the spread of this deadly disease. Thailand, which had been so successful in combating TB in the past, has contributed to the widespread misconception that the disease has already been beaten.
The disease, however, has come back with a vengeance in recent years mostly in developing countries, including Thailand. Public health experts have expressed concern about the emergence of drug-resistant strains of the disease and the Aids pandemic, which, they say, could combine to bring death and suffering to millions of people worldwide.
Thailand was caught by surprise when the World Health Organisation ranked the country 17th out of 22 countries in the world with the highest rates of TB infection. According to a Public Health Ministry estimate, the TB rate in densely populated areas like Bangkok could be as high as one in every 500 people.
Most infected people are not aware of the disease, which is caused by the Mycobacterium tuberculosis bacillus and can be spread through the air like the common cold. According to the WHO, if left untreated, one person with infectious TB will pass it on to an average of 12 to 20 people, and that two to four of these will develop infectious TB.
According to the WHO, even though the global TB rate may have stabilised over the past few years due to greater awareness among public health officials and control efforts, the actual number of people with TB has increased markedly as a result of an increase in the world's population. The world health body said there were about 8.8 million new TB cases and 1.6 million deaths due to the disease in 2005.
Thailand is a classic example of how a high rate of HIV/Aids infection can fuel a TB resurgence. It has taken Thai health authorities years to shed complacency and wake up to the threat posed by the HIV/Aids-TB combination to the country's public health system.
A recently released study by Dr Amara Soonthordhada entitled "TB Policy in Thailand: A Civil Society Perspective" exposes a striking lack of social and political commitment to control tuberculosis, one of the leading causes of death in Thailand.
Due to the absence of TB awareness among members of the Thai public, there is little understanding of how TB is spread and the fact that it can be cured. According to the study, many patients do not seek treatment because of the social stigma attached to the disease, a lack of information, and the high costs of the cure.
The emergence of drug-resistant strains of TB is a great possibility in Thailand where too many people have developed the habit of self-medicating by buying medicines, like antibiotics, from local pharmacies - many of which are not staffed by qualified pharmacists - and then not bothering to complete the whole course.
Health authorities are just now beginning to encourage people with TB to come forward to seek free treatment. TB can be cured with a treatment regimen that typically takes six months to complete. The most important thing is to ensure that patients take the right dose of medicine and complete the whole course to prevent strains of TB becoming drug resistant.
The Public Health Ministry's statistics shows that while TB rates fell by 50 per cent from 1985 to 1991, the HIV/Aids epidemic may have contributed to a resurgence of TB, which kills about 12,000 people a year in this country.
Public Health officials will find it difficult to identify people with TB. The standard, error-prone procedure for diagnosing tuberculosis was developed some 100 years ago and it involves putting sputum samples under a microscope and lab technicians identifying the bacteria that cause TB. That's why a public awareness campaign is very important to alert people of the looming public health threat.
For a country like Thailand where HIV/Aids and TB tend to combine with devastating effects, public health authorities must rationalise their work by merging HIV/Aids and TB treatment programmes in order to lower the death rate from TB, which is curable.
posted by AIDS-Care-Watch at 10:13 am
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