( The disease kills 4,400 people per day, two million people annually worldwide )
Tuberculosis (TB), the second leading cause of death from infectious diseases in the world, remains a major health challenge in Pakistan.
Even though Pakistan has achieved 100% DOTS (Directly Observed Treatment, Short Course) coverage, 80% case detection rate and 87% treatment success rate, the country still ranks 8th globally among the 22 high burden countries, and contribute 43% of the disease burden towards the Eastern-Mediterranean Region of World Health Organisation. In Pakistan, nearly 1.5 million people suffer from TB where as more than 300,000 new cases add up to the country’s escalating TB burden every year. The TB incidence in Pakistan is reported at 181 per 100,000 persons.
Health experts say that every year, thousands of people die of a disease, which is completely preventable, and 100 per cent curable. 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, they say.
World TB Day falling on March 24 each year is designed to build public awareness that tuberculosis remains an epidemic in most part of the world, causing deaths of several millions people each year, mostly in the third world. ‘TB Se Nijaat, Naujawanon Key Saath’ (Getting rid of TB with the help of youth) has been devised slogan for the year 2009, along with 2008 slogan, ‘I Am Stopping TB’ to sensitise the younger generation to make efforts against eradication of the disease. Youth are the prime target of TB control in Pakistan where 70% of new TB patients belong to productive age group between 14 to 49 and 30% belong to the age group 14-24”.
63 per cent of total population of Pakistan consists of young people aged less than 25. According to WHO estimates, one third of world population is infected with TB. Someone in the world is newly infected with TB bacilli every second. Every year nine million people develop TB worldwide, more than 95% of which are in the developing countries. TB kills two million people annually, or 4,400 people per day. TB is the leading cause of death among people living with HIV.
There is a dire need to increase awareness among general public and especially among youth through mass media, TB weeks and advocacy seminars and to spread the message that TB is preventable and curable. “The WHO is working out to cut TB prevalence rates and deaths to half by 2015,” multi-drug resistant TB (MDR-TB), extensively drug-resistant TB (XDR-TB), HIV-associated TB and weak health systems are major challenges being confronted by countries in third world including Pakistan.
According to official data, women and children are most vulnerable to Tuberculosis. In 2001, the government of Pakistan declared TB a national emergency. If left untreated, one person with active TB might infect 10 to 15 people during one year.
TB is a disease of poor. “Malnourished, diabetics, smokers, prisoners, elderly, HIV infected individuals, healthcare workers, alcoholics and close contacts of infectious TB patients are at high risk to develop TB”.
General public should be educated that TB is spread from person to person through air. 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.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 100 percent curable. “TB should be cured in order to stop TB.”
Patient should take anti-TB drugs as advised by the doctor under the supervision of health worker/some responsible person for eight months without interruption. The anti-TB drugs can be obtained free of cost from any healthcare centre, government hospital or TB Centre. Free diagnostic and treatment services are available at 5,000 public health establishments throughout the country.
Patient should not leave treatment without advice from a qualified doctor. “During anti-TB treatment, mother can also breastfeed her child. Patients should not be stigmatised and must receive full support from family and community. 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), the most dangerous form of TB with no treatment. “Remember! Complete TB treatment is the most effective means of TB prevention.”
On preventive measures, it can be prevented by BCG (Bacille Calmette Guerin) vaccination and by awareness raising campaigns on mass scale. “TB patients should be advised to cover mouth while sneezing or coughing and not to spit on different spots. Newborn infants must be immunized against TB with BCG vaccine immediately after birth.”
It is important that National TB Control Programme (NTP) has engaged 500,000 youth volunteers and students all across country to spread the basic information about various aspects of the disease.
Fighting TB means fighting poverty, treating patients so that they can resume work, reducing stigma, ensuring affordable access to drugs and promoting advocacy so that patients can have a voice. “With the will, the funds and the action, together we can Stop TB!”.
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