HYDERABAD: Xray not enough to diagnose TB: experts
By Our Correspondent
HYDERABAD, Jan 17: Speakers at a symposium on “war against tuberculosis: TB management in line with WHO guidelines” here on Thursday have called upon the doctors to take extra ordinary care while diagnosing patients with sputum smear positive and not to base their diagnosis on X-ray tests alone.
The speakers at the conference organised by WYETH, Pakistan, at a local hotel, emphasised the need for tests of sputum smear microscopy and culture for diagnosis of TB positive.
They said that the there were countless number of cases of over and under reading of X-ray tests by doctors which had proved very harmful for the treatment of the patients.
They maintained that the general practitioners must keep in mind that their diagnosis, based on the reading of X-rays, could be incorrect. They pointed out that there were cases on record in which the patients did carry the symptoms of TB but their tests remained negative.
Renowned chest specialist Dr Abdullah Jan Pathan informed the audience that 25 per cent of deaths in the country were due to TB and added that there were instances in which 80 per cent of patients who were TB positive reported to doctors very late.
Talking on the history of TB, he referred to many luminaries including Nelson Mandela, Quaid-i-Azam Mohammad Ali Jinnah, the wife of Jawaharlal Nehru, the brother of President Nixon, King George V, King Henry VI etc, who either suffered from TB or died of it. He said that even 5,000 to 6,000 years ago, TB symptoms existed in bones of human beings.
Dr Pathan said that the war against TB was going on since 1882 in different ways and added that one third of the world population was affected with TB.
He said that according to WHO’s study, TB could affect any organ of the body.
He regretted that in most of the cases, the patients reported to general practitioners instead of specialists notwithstanding the gravity of the situation.
He also deplored that substandard medicines could be registered in Islamabad by way of corruption and claimed to have possessed some proofs in this regard.
He urged the patients not to adopt method of self medication and added that they should get themselves tested and medically examined from a recognised laboratory because most of the laboratories were being operated and maintained by the technicians instead of pathologists.
Regarding non-compliance on the part of the patients, he said that general practitioners did not give proper doses to the patients, who also subsequently gave up treatment half way, exposing themselves to the deadly disease more easily.
He added that poverty was another important factor that made the matters complicated for the patients’ treatment.
He criticized successive governments for scraping health policies and other programmes. “It is the question of political commitment and budget as well if we really want to wage a war against TB”, he said.
The head of the JPMC chest department, Dr Nadeem Rizvi, said that the doctors should make it mandatory that every PTB (pulmonary TB patients) must submit three samples of sputum smear for microscopy.
He added that study showed that doctors and para medical staff carried higher risk of TB infection because they were easily exposed to the patients while treating them.
He called upon the general practitioners to refer cases of TB patients to specialists if they were not satisfied with the reading of X-ray.
He said diabetes and renal failure also diverted patients to TB easily.
The head of the department of pulmonology, Liaquat National Hospital, Karachi, Dr Musawir Ansari said that the success of DOTS was directly linked with the active participation and cooperation of private and public sectors.
He, however, did not rule out certain changes and amendments in the method of DOTS keeping in view the environment of cities.
The doctors referred to different statistics pertaining to the medicines, their efficacy and the number of doses, which vary among the patients given the nature of their disease.
