14 March 2004	Sunday	22 Muharram 1425

KARACHI, March 13: Pakistan plans to have 100 per cent coverage of DOTS treatment of tuberculosis in the government hospitals all over the country by 2005, the manager of the National TB Control Programme (NTBP), Dr Karam Shah, said here on Saturday.

He was speaking at the 6th Biennial Conference of the Pakistan Chest Society on 'Tuberculosis and lung diseases,' on Saturday.

Dr Shah said the Directly Observed Treatment Short (DOTS) course of TB was being effectively used in the government hospitals all over the country.

Dr Karam Shah said every year in Pakistan about 250,000 new cases of TB were detected and the number of deaths caused by this disease was about 60,000 per year.

Dr Peter Davies, Consultant Chest Physician for Liverpool, UK, highlighted the global scenario of TB and said about one-third of population was already infected with this germ.

Serious measures must be taken by the governments to control this epidemic.

The multi-drug resistance of TB (MDRTB) is a serious issue as it is like a time bomb. "We must prevent the increase in MDR cases of TB," he said adding: "If this bomb explodes, we will not be able to control this severe threat to mankind."

A chest specialist Dr Bill Mc. Kelvie, who is using DOTS programme in Mirpurkhas, underlined the need that the private sector should also be involved in use of DOTS.

Prof Javed Khan of Aga Khan University said that without involving the general physicians and the private sector in TB control, the efforts would not bear fruit.

He said about 80 per cent TB patients were still going to the private sector hospitals and general practitioners for diagnosis and treatment.

Prof Martyn R. Partridge of Imperial College explained the situation of asthma in the world.

He said over 5 million people were suffering from asthma and this number was increasing.

He said despite the fact an effective treatment of the disease was available, many people did not know about it.

Dispelling the notion about the side-effects of using steroids in inhaler, he said there was no side-effect of it because a minute dose was used which helped open the airway.

A Pakistani expert, Dr Nadeem Rizvi, said that asthma was spreading in Pakistan. Earlier, 10 per cent people were affected, but now the number had increased to 19 per cent.

He said children were more prone to this disease because of air pollution due to diesel smoke emission from old buses in urban areas. Dust on carpets and curtains were also the main reasons for spread of asthma, he added.

Dr Rizvi said that inhaler was the best treatment of the disease, but more than 90 per cent patients in Pakistan did not know the correct use of it.

In her presentation, Dr Shahina Qayoom of JPMC gave an overview of prevalence of TB in the SAARC region.

She said despite the fact SAARC countries bore 22 per cent of the total global population, the total global TB burden in SAARC was more than 29 per cent.

The region was still far behind the WHO target of 70 per cent case detection rate, she said, adding that evidence suggested that less number of female TB suspects were visiting the health centres and even less number were being diagnosed as TB patient.

Treatment compliance was better in the female TB patients.

Bangladesh, India and Pakistan were among the high burden countries, she added.

Giving details, she said about 2.5 million new cases were reported every year (all types) and 1.10 million Sputum Smear Positive cases were recorded per year. About O.6 million deaths per year were reported.

She pointed out that the studies suggest that in the developing world an adult with TB could lose an average of 3-4 months of work time, which results in average lost potential earnings of 20-30 per cent of annual household income.

Dr Mati-ur-Rahman, Medical Director at Afif General Hospital, Riyadh, who had worked at the JPMC and Ojha Institute of Chest Diseases, said TB was effectively treatable provided drugs were used for proper duration. Correct diagnosis, dosage, duration were essential for treatment of TB. Half treatment of TB was more dangerous than non-treatment, he added.- APP