TB Fatally Stalking Southeast Asia's HIV Patients

By, News Post India, April 12, 2008

India, Myanmar, Nepal and Thailand have some of the highest rates of tuberculosis (TB)-HIV co-infection in Southeast Asia, says a World Health Organisation (WHO) report.

The prevalence rate of TB among people living with HIV has been estimated as 5.2 percent in India, 7.1 percent in Myanmar, 3.1 percent in Nepal and 7.6 percent in Thailand, says the report on tuberculosis in the region.

Patients with their immune systems disabled by HIV/AIDS face a 30 times greater risk than others of contracting TB.

And for HIV/AIDS patients in India, that's bad news because the country has the highest incidence of TB in the world. India is home to over 3.4 million TB patients - about one-fifth of the global figure.

For the WHO, India is part of the Southeast Asia region along with Bhutan, Bangladesh, Indonesia, Myanmar, Thailand, the Maldives, Sri Lanka, Nepal, Timor-Leste and North Korea. The region has 25 percent of the world's population but accounts for more than one-third of the global burden of TB, the report said.

'TB is the single most life-threatening infection and the leading cause of mortality among people living with HIV infection in the region,' it added.

'The rapidly expanding HIV epidemic in the region is a growing concern. The HIV epidemic has reached a generalised stage in Thailand, Myanmar and in six states in India,' the report pointed out.

The six high-prevalence states in India are Andhra Pradesh, Karnataka, Manipur, Maharashtra, Nagaland and Tamil Nadu.

India has 2.5 million plus HIV patients.

The report said during 2006 in 14 states in India, 25,055 HIV infected TB suspects were referred to the Revised National TB Control Programme (RNTCP) services. Of these, 4,829 were diagnosed as HIV infected TB cases.

'The course of the TB/HIV epidemic in Southeast Asia will depend heavily on efforts to prevent and control both TB and HIV, and decisive steps must be taken now to combat the dual epidemics,' the WHO report said.

Of the 38.6 million people estimated to be living with HIV in the world at the end of 2005, more than four million are in Southeast Asia, said the recently released report on tuberculosis in the region.


Source: http://newspostindia.com/report-48024

TB still big public health problem

By, Charles Mpaka, The Daily Times, April 14, 2008

National Tuberculosis Control Programme (NTP) said last Friday that TB was still a big public health problem in Malawi inspite of successes the country has registered in the fight against the disease.

NTP said this in Blantyre at a briefing intended to enable the media come to grips with technical issues about TB.

NTP said from 2003, the number of TB cases from the districts has not gone up or down.

“This does not mean that TB has become a less problem,” said NTP Director Felix Salaniponi.

“It is still a big public health problem. It is killing people. Because of its chronic nature and the length of time it takes to cure it, time is being spent on caring for patients.”

Salaniponi reported that 75 people develop the disease everyday while 15 others die from TB every day.

“The major challenge is that we are not finding many cases that should have been coming to us. In that case, the TB situation will not go down because these cases we have not detected could be spreading the disease to others. This contributes to TB being an emergency case in Malawi,” Salaniponi said.

The World Health Organisation ranks Malawi as achieving a low detection rate of less than 50 percent, especially among the poor who are underserved and face problems such as geographical distance and high opportunity costs to access TB diagnostic and treatment.

Malawi recorded a 98 percent cure rate between 1984 and 1987 but that was eroded by HIV/Aids, which constitutes another big challenge in the fight. According to NTP, 70 out of every 100 TB patients are HIV positive.

The WHO recently ranked Malawi as second best in Africa after Rwanda HIV testing rates in TB settings.

In terms of cure rate, Malawi recorded a 74 percent rate in 2005. This rose to 76 percent in 2006. This, however, was 19 percent lower than the cure rate WHO requires.

The NTP director said Malawi’s efforts on TB were also being threatened by the presence of the multi-drug resistant TB (MDR-TB).

He said although there are very low MDR-TB cases in Malawi currently, its scale of devastation could not be ignored.

If the current MDR-TB situation is mismanaged, it could lead to development of the almost incurable extensively drug resistant TB (XDR-TB).

“It takes too long to treat, about 24 months and the drugs are toxic. A patient will have to get an injection every day for six months. And it is like bush fire that could go wild to become XDR-TB,” Salaniponi said.

According to NTP, it takes up to K3 million to treat an MDR-TB patient, a condition that often results from default of ordinary TB treatment.

In response to the emergency status of TB in the country, government last year developed a two-year plan of action for TB.

The plan, motivated by the low detection rates, seeks to bring universal access to TB diagnosis.

Through the plan, NTP will, among other things, expand community response and establish TB corners in all health facilities where people can easily access or demand for TB related services.

The plan will intensify TB detection and screening of high-risk groups like prisoners.

It is reported that between 8 and 10 percent of TB cases in Malawi come out of prisons and that prisoners are 10 to 15 times more susceptible to contract the disease than the outside society.

Source: http://www.dailytimes.bppmw.com/article.asp?ArticleID=9078

TB fatally stalking Southeast Asia's HIV patients

By, Thaindia, April 12, 2008

India, and Thailand along with Myanmar and Nepal have some of the highest rates of tuberculosis (TB)-HIV co-infection in Southeast Asia, says a World Health Organisation (WHO) report. The prevalence rate of TB among people living with HIV has been estimated as 5.2 percent in India, 7.1 percent in Myanmar, 3.1 percent in Nepal and 7.6 percent in Thailand, says the report on tuberculosis in the region.

Patients with their immune systems disabled by HIV/AIDS face a 30 times greater risk than others of contracting TB. And for HIV/AIDS patients in India, that’s bad news because the country has the highest incidence of TB in the world. India is home to over 3.4 million TB patients - about one-fifth of the global figure.

For the WHO, India is part of the Southeast Asia region along with Bhutan, Bangladesh, Indonesia, Myanmar, Thailand, the Maldives, Sri Lanka, Nepal, Timor-Leste and North Korea. The region has 25 percent of the world’s population but accounts for more than one-third of the global burden of TB, the report said.

“TB is the single most life-threatening infection and the leading cause of mortality among people living with HIV infection in the region,” it added.

“The rapidly expanding HIV epidemic in the region is a growing concern. The HIV epidemic has reached a generalised stage in Thailand, Myanmar and in six states in India,” the report pointed out.

The six high-prevalence states in India are Andhra Pradesh, Karnataka, Manipur, Maharashtra, Nagaland and Tamil Nadu. India has 2.5 million plus HIV patients.

The report said during 2006 in 14 states in India, 25,055 HIV infected TB suspects were referred to the Revised National TB Control Programme (RNTCP) services. Of these, 4,829 were diagnosed as HIV infected TB cases.

“The course of the TB/HIV epidemic in Southeast Asia will depend heavily on efforts to prevent and control both TB and HIV, and decisive steps must be taken now to combat the dual epidemics,” the WHO report said.

Of the 38.6 million people estimated to be living with HIV in the world at the end of 2005, more than four million are in Southeast Asia, said the recently released report on tuberculosis in the region.

Source: http://www.thaindian.com/news-snippet/tb-fatally-stalking-southeast-asias-hiv-patients-4729.html

Lethal TB strain now in Namibia

By, Christof Maletsky, Namibian News, April 2, 2008

Health professionals are quietly treating up to 24 confirmed cases of extensively drug-resistant tuberculosis (XDR-TB) - the worst form of TB with seriously limited treatment options and chances of cure - in Namibian hospitals.

Well-placed health sources have confirmed to The Namibian that the extreme form of TB is currently under control, but expressed fears that the country does not have the capacity to deal with a major outbreak of XDR-TB.

The Namibian had been aware of at least one case being treated at Walvis Bay since December, but health sources said this week that the situation was worse than initially thought.

On Friday, Health Minister Dr Richard Kamwi only expressed fears that Namibia was about to record its first cases of XDR-TB.

TB can usually be treated with a course of four standard, or first-line, anti-TB drugs.

However, if the drugs are misused or mismanaged, multi-drug-resistant TB (MDR-TB) develops and later progresses to extensively drug-resistant TB (XDR-TB).

"There are currently 254 cases of multi-drug-resistant TB under treatment throughout the country.

This is a great concern and is a clear indication that it is only a matter of time before we will have extremely drug-resistant cases, known as XDR Tuberculosis, in Namibia," Kamwi said at the World TB Day event staged at Mariental on Friday.

He said experts in the Ministry of Health were busy reviewing all TB cases with drug resistance to verify the extent of the problem.

"Given the large number of cases, we may well find some incurable XDR-TB amongst this group," Kamwi said.

Kamwi confirmed that Namibia was the country with the second highest TB incidence in the world after Swaziland, with 15 244 cases reported last year alone.

The host region of this year's TB Day event, Hardap, had the highest incidence of TB in Namibia last year, reporting a worrying 1 294 cases per 100 000 people, Kamwi said.

The TB situation is exacerbated by the HIV-AIDS epidemic in the country.

"HIV infection is the major known individual risk factor for the development of TB disease.

Last year 8 186 TB patients representing 54 per cent of the total notified patients were tested for HIV and 59 per cent were HIV positive," Kamwi said.

He said the impact of the dual infection of TB with HIV-AIDS was a major cause for concern, in particular as it affected the Namibian workforce.

"We are experiencing a decline in work productivity; this then results in a decrease in household income, which jeopardises health, nutrition, sanitation, safety, education and care in our nation.

The effect of disease burdens on the workforce can essentially stunt the necessary socio-economic growth on our path toward Vision 2030," the Minister warned.

He called on health workers to be proactive, focused, tireless and united in their responses against the two diseases.

"Clearly, if we are to make an impact in the control of TB, and considering the reported MDR-TB and the concern related to the XDR-TB, we need more skilled healthcare workers," Kamwi said, appealing for more donor assistance to scale up the procurement of medicines, strengthening hospital infrastructure and enhancing control in TB wards.

Source: http://www.namibian.com.na/2008/April/national/08F606ADE1.html