Nearly 1000 people die of Tuberculosis in India everyday

By, CNN-IBN, Ginny Narula, March 24, 2008

New Delhi: Nearly a 1000 people die of Tuberculosis in India every day which is more than the number of deaths caused by Malaria, HIV and Hepatitis combined.

Sushil Kumar has been suffering from tuberculosis and has come all the way from Jharkhand to Delhi to get himself treated.

“I had a bad cough, doctors asked me to go in for a sputum test and I was diagnosed with tuberculosis,” says Kumar.

While incidence of TB has dropped in countries like the US, the increase in drug resistant strains is a huge cause of worry for doctors, especially in countries in Asia and Africa, where 83 per cent of the world's cases of tuberculosis are reported.

Another trend that has doctors worried is that TB is no longer a poor man's disease. Affluent urban India is adding to the number of deaths caused by Tuberculosis.

Even though there has been a decline in numbers. India continues to have the highest number of TB cases followed by China, Indonesia, South Africa and Nigeria.

According to WHO report 2007, in India the death rates due to TB have declined from 42 per 100,000 population in 1990 to 29 per 100,000 population in 2005.

However, the rate of detection of new cases has fallen to 3 per cent from an average of 6 per cent in the preceding five years. This is despite India boasting of the biggest TB detection programme in the world.

Initially these DOT centers were very active however, with time they are not that pro-active due to which there is a decline in rate of detection.

These statistics are worrisome as the higher the cases of early detection, the lower the chance of transmission of the disease and gives a better chance to cure.

Source: http://www.ibnlive.com/news/nearly-1000-people-die-of-tuberculosis-in-india-everyday/61843-17.html

1/5th of drug resistant TB patients live in India

By, Howrah News Service, March 24, 2008

Nearly one-fifth of the world’s TB patients, who have acquired multi drug resistant tuberculosis, are in India.

Presenting a bleak picture of the country’s national TB control programme, the latest World Health Organisation (WHO) report released on Monday has warned that ‘’rising multi drug resistant TB’’ could ‘’ruin’’ India’s efforts to control tuberculosis.

According to the report, India and China record the highest number of TB cases globally. The other high-burden countries are Bangladesh, Indonesia, Burma and Thailand.

Out of the 22 countries that record TB globally, these five countries together have over two million cases or 95 per cent of all cases globally, the report has said.

Commenting on India’s performance in the fight against TB, the report said, "The data for the cohort of infectious TB patients completing their treatments in 2006 for the first time or repeating it after previous failures or defaults shows less than optimal results."

It said that defaults and treatment failures, both among first time treatment seekers and among re-treatment cases raises the probability of multi drug resistance.

"Achieving universal coverage of treatment services is not enough; it needs to be matched by consistent, universally accepted standards of treatment outcomes," said the report.

India has continued to report high morbidity and mortality due to tuberculosis and as many as 1.39 million cases were reported in 2006, said the report on tuberculosis in the South East Asia region.

In 2005, more than 3.2 lakh deaths were reported due to tuberculosis in the country, it said.

The region, with 4.97 million TB cases, carries over one-third of the global burden of TB, said the report. It was revealed that most cases occur in the age group of 15-54 years.

Source: http://howrah.org/india_news/7917.html

http://www.timesonline.co.uk/tol/news/uk/health/article3599420.ece

By, Melanie Reid, Timesonline, March 22, 2008

Health officials are screening the close contacts of a man who has become Britain’s first case of a virtually untreatable form of drug-resistant tuberculosis.

The man, believed to be a Somali asylum-seeker in his thirties, has a rare strain, Extremely Drug Resistant TB (XDR-TB), which has a high mortality rate.

The World Health Organisation (WHO) says that XDR-TB accounts for possibly only 2 per cent of the 9 million cases of tuberculosis in the world, but that it poses a grave public health threat, especially in populations with high rates of HIV and where there are few healthcare resources.

Health chiefs said yesterday that close contacts of the patient, who is in isolation at Gartnavel General Hospital, Glasgow, were being screened. He has been in the hospital since January.

Dr Oliver Blatchford, consultant in public health medicine in Glasgow, said yesterday: “It is no more infectious than ordinary TB but it does require different treatment. The contacts of this case are being screened in the same way as ordinary TB contacts. They will be monitored closely to ensure that any further cases are identified early and treated quickly.”

A health board spokesman added that the man had been admitted to hospital at the end of January but was unable to give any personal details or provide information about his condition.

It is understood that the man arrived at Heathrow last November and when screened for infectious diseases was found to have TB scarring on his lungs.

The condition was not active, however, and the man told doctors he had recently had a six-month course of treatment for TB. After an immigration interview, he was allowed to go to Scotland, where the disease became reactivated.

XDR-TB poses a far greater challenge to doctors than MDR-TB (Multidrug Resistant TB), which is resistant to at least the two main first-line tuberculosis drugs, isoniazid and rifampicin. XDR-TB is a form of MDR-TB that is also resistant to three or more of the six classes of second-line drugs. Doctors can only try to contain the disease with a cocktail of second-line drugs. In some cases, part of the lung can be cut out.

This is the first case reported in Britain since the revised definition of XDR-TB was published by the World Health Oorganisation in 2006. Recent findings from a survey of data from 2000-04 found that XDR-TB had been identified in all regions of the world but was most frequent in the former Soviet Union and Asia.

Professor Peter David, the secretary of TB Alert in Britain, said that drugs could contain the disease but not cure it. Treatment takes 12-18 months and is estimated to cost more than £100,000 per patient.

Global killer

— Skeletal remains show that prehistoric human beings had the disease in 4000BC, and tubercular decay has been found in mummies from 3000-2400BC

— Two billion people, one third of the world’s population, are infected with the bacterium that causes TB

— Every 15 seconds someone dies from TB. Two million people die from it each year

— Eighty per cent of TB cases are concentrated in 22 “high-burden” developing countries, but no corner of the world is safe. The WHO declared TB a global emergency in 1992

Source: Times database : http://www.timesonline.co.uk/tol/news/uk/health/article3599420.ece

WHO warns more TB cases slipping through detection

By, The China Post, March 19, 2008

The World Health Organization warned Monday that more new tuberculosis cases are slipping through the detection net, as countries fail to keep up with rapid progress made in earlier years.

"After some years of good trends for tuberculosis control, 2006 documents a slowing of progress -- the rate at which new cases were detected increased only slightly compared to recent years," WHO director-general Margaret Chan told journalists.

"This slowdown in progress comes at a time when numbers are still way too high," she added.

The WHO estimates that only 61 percent of all TB cases worldwide are registered.

In 2006, some 9.2 million new cases of TB were detected against 9.1 million in 2005, said the WHO in its annual report on TB control.

The WHO estimates that, including non-detected cases, there were 14.4 million cases of the disease worldwide in 2006.

Between 2001 and 2005, detection rates were increasing by six percent a year, but in 2006, this rate was halved to three percent.

"This is not a good sign because our target is to detect all cases that exist. There is 39 percent that we are unable to find, but which we think is there," said Mario Raviglione, who is director of the WHO's Stop TB department.

The slowdown was attributed to the fact that some national programs that were making steady progress during the last five years have not been able to continue at the same pace in 2006, said the WHO.

In addition, in many African countries, there has not been any increase in the detection of TB cases through national programs.

Others are slipping out of the detection net as they are treated by private care providers, and by NGOs or community groups, added the WHO.

"We've entered a new era. To make progress, firstly public programs must be further strengthened. Secondly we need to fully tap the potential of other service providers," said Chan.

In 2006, 200,000 TB deaths were recorded among people who were infected with HIV, while an estimated 1.5 million people without HIV also succumbed to tuberculosis.

Nearly a half million new cases of multi-drug resistant tuberculosis occur each year worldwide, or around five percent of the nine million new cases in total, the WHO said then.

Source: http://www.chinapost.com.tw/health/infectious%20diseases/2008/03/19/147825/WHO-warns.htm