Published: Fri, March 24, 2017
Medicine | By Megan Pierce

Rise in number of TB cases among youngsters in Mumbai

Rise in number of TB cases among youngsters in Mumbai

This photomicrograph reveals Mycobacterium tuberculosis bacteria using acid-fast Ziehl-Neelsen stain; Magnified 1000 X. The acid-fast stains depend on the ability of mycobacteria to retain dye when treated with mineral acid or an acid-alcohol solution such as the Ziehl-Neelsen, or the Kinyoun stains that are carbolfuchsin methods specific for M. tuberculosis. In 1993, the World Health Organisation (WHO) declared TB a global health emergency with the emergence of multidrug-resistant M.tb and when rates of TB rapidly rose with the HIV epidemic.

Until past year, a total of 223,922 people were detected with tuberculosis, including 9,700 multi-drug-resistant tuberculosis (MDR-TB) patients.

With the exception of Africa, the number of TB deaths and the TB incidence rate have fallen around the world.

The challenge: Out of those TB patients who reached the government system - 72 per cent of India's total TB cases in 2013 - more than half a million patients were either not diagnosed correctly, or diagnosed but not registered for treatment. Of these cases, 1,252 TB cases (43 per cent) were from non-residents.

TB is spread via aerosol infection. If left untreated, a person with active disease can infect up to 15 people simply by coughing or sneezing.

About one-third of the world's population has latent TB, which means people have been infected by the TB bacteria, but are not (yet) ill with the disease and can not transmit it.

However, Dr Indu Bubna, Chest Physician, SRV Hospital, said, "The rise in the figures of TB is also due to the increased awareness among people about the disease".

There was a decades-long lull in TB drug development after the last major antibiotic, rifampicin, was licenced in the 1970s. More than 100 countries, including Malaysia, are already using the test.

A pre-school in Clementi was reported to have a staff member who had active pulmonary TB, requiring the initiation of a large round of contact tracing.

Progress against TB has come-even prior to the advent of effective anti-TB drugs-via alleviation of poverty and addressing other social determinants such as overcrowding or social equality; these should be considered holistically in any effort directed toward TB control.

"When resistance occurs the treatment can take years and the drugs used have unpleasant and sometimes serious side effects". Certainly, more can be done to improve the situation and close existing loopholes.

Third, in the context of rapidly changing worldwide aid, predictable and sustainable funding is required to ensure adequate and uninterrupted supply of TB diagnostics materials and essential medicines thus there is the need to increase domestic funding to safeguard the achievements made so far. "Drug-resistant tuberculosis is not standing still; neither can we".

TB patients require higher levels of energy and metabolic immunity to cope with the infection, and understandably this need is higher in children during to their growth phase. Abnormal chest X-rays which have been passed should be audited by the relevant authorities or institutions and feedback should be promptly given to the evaluator.

Patients are also in greater personal danger due to the emergence and spread of MDR-TB around the world, a message brought home by the Parklane cyber cafe and Ang Mo Kio cluster of cases that made the news in 2012 and 2016.

There is a $25 charge for the skin test. The science to treat TB is available. However, the costs of embarking on such a strategy are substantial, as are manpower requirements, and these factors would need to be weighed with cost-effectiveness prior to making such strategies into policy for migrant screening.

What's required is a new approach of working with strong and diverse partners. "On this day, I want to stress the importance of identifying the signs and symptoms of active TB to accurately diagnose and treat patients, as well as the importance of testing at-risk patients for latent TB before it progressive to active TB". Support should be given to those who require active and latent TB testing according to worldwide guidelines.

In addition, given that Sri Lanka has implemented several national policy programmes and secured funding through the GFATM, these funds could be effectively utilized by enhancing the present institutional arrangements to control the spread of the disease.

"Even when the drugs work‚ TB is hard to cure and requires months of treatment with a cocktail of drugs". During anti-TB treatment, mother can also breastfeed her child.

Through the provision of facilities for diagnosis, treatment and prevention of the disease, attainment of high treatment success rate of over 90 per cent and reduction of financial barriers to access the appropriate care and treatment, the country is on the verge of halting the occurrence of the disease.

Like this: