KARACHI: Poverty, lack of political will spreading TB: doctors
KARACHI, July 27: Health experts at a seminar said that lack of political will coupled with poverty and consequent malnutrition was causing surge in tuberculosis cases in the country.
The seminar on "Tuberculosis: a curable disease" was held at the Sindh Government Hospital, Korangi, on Tuesday. The chest medicine department's head of the Jinnah Postgraduate Medical Centre, Prof Nadeem Rizvi, said that tuberculosis had never been eradicated from Pakistan.
However, he opined that the Directly Observed Treatment Short course (DOTS) of eight months duration, if adequately complied had proven to be a successful strategy. Though tuberculosis was curable, he said, efforts to ensure adequate intervention through timely and quality availability of drugs have always remained low in national priorities.
It was mentioned that women and children were the major sufferers and that the disease could inflict people pertaining to any group of age - particularly those who may be malnourished.
Dr Rizvi specifically underscored the need for quality drugs for tuberculosis and said that the low quality of medicines could not only develop drug resistance but also turn into a major and direct source of spreading bacteria making several other healthy individuals contracting the infection.
Elaborating his stance, he maintained that people with poor nutritional status, often an outcome of poverty, owing to their weak immunity were more prone to contract infection.
To prevent any such situation, the senior physician strongly recommended that regular assessment of drug quality be made mandatory particularly at the WHO-recognized laboratories in accordance to international standards.
Besides, he said that concerted efforts were required in the country to arrest poverty and declining living standards with direct impact on individual's health as well as the environment and surroundings.
Referring to the issue of spurious drugs while mentioning the instances when drugs were found decomposed, he suggested need for a modality under which adequate clinical trials could be arranged to assess impact of medicines on local population.
Dr Nadeem Rizvi mentioned that during the last 50 years the world including Pakistan was provided with several drugs and combination of medicines, yet over a million women died of tuberculosis each year across the world.
"Tuberculosis is one of the infectious diseases that is the commonest killer of pregnant," he said adding that 95 per cent of all new tuberculosis cases and 98 per cent of TB-induced deaths are registered in the developing world.
Referring to a study conducted in India, he said that 75 per cent of urban-based TB patients as compared to 67 per cent of their rural counterparts went into debt because of their ailment while 11 per cent of children across India had to discontinue education and another eight per cent were compelled to join work force due to tuberculosis which had struck the family.
Dr Rizvi said that no new tuberculosis drug had been introduced for the last 20 to 25 years owing to which drug resistance had emerged as a major problem. However, he pointed out that the DOTS had been introduced as a strategy to improve drug compliance which was the most effective way to cure the disease - largely stigmatized.
The chest medicine department head of the Korangi Government Hospital, Dr Shakeel Ahmed Siddiqui, in his presentation mentioned that the country shared 44 per cent burden of tuberculosis cases in the Eastern Mediterranean Region.
Dr Shakeel Ahmed said: "Pakistan ranks sixth among the world community reporting with the highest incidence of the disease." Under the given scenario when the disease has been declared a national emergency and the DOTS strategy has been introduced in the country, he said that due stock must also be taken of the fact that TB Control Programme was the primary healthcare programme.
He said that the DOTS programme was initiated about 18 months back at the Korangi Government Hospital and since then it had been emerged as the most efficient mode to help patient gain absolute recovery.
Dr Shakeel mentioned that the eight-month treatment programme had done wonders for many of the individuals who had given up all their hopes. In this regard, the case of a 23-year-old lady was presented at the seminar showing that despite developing a serious complications under which she along with TB had also inflicted meningitis, she managed to recover owing to proper and regular medication.
The very lady, who was divorced due to her ailment, was stated about to be remarried. According to the physician, the most intense care period under DOTS is the first two months of the medication during which the patients are required to take prescribed drugs in front of doctors or relevant healthcare professionals, while the very duration is also utilized to motivate the patients, their family members and the community to ensure proper and regular drug therapy to prevent any possible relapse. - APP
