KARACHI, March 23: The lack of concerted efforts to improve nutritional status of TB patients as well as that of people in general is feared to affect the ongoing fight against the disease under the DOTS programme.
Tuberculosis, termed a disease of poverty, has already afflicted about 1.5 million people in the country with 250,000 fresh cases surfacing each year, while only one in five new cases is ever detected or treated.
The government, which has already launched a comprehensive TB control programme under the Directly-Observed Treatment Strategy (DOTS) with provision for absolutely free of cost and regular availability of required drug regimen, is yet to give due consideration to the social aspect for containment of the disease.
Ironically, the country’s nutritional programme is being run vertically and has not been integrated with the TB control programme, despite the fact that it is the poor nutritional status of the people which enhances their vulnerability to the ailment and also increases the recurrence chances.
Physicians while talking to APP stressed the need for giving due importance to improve health status of the people as it was mainly the poor nutritional status which weakened their immunity and made them susceptible to the disease.
“Without giving due attention to the provision of food containing all nutrients in adequate quantities and expecting drugs to play wonders will be quite unrealistic,” doctors observed.
According to them the administration of strong drugs on the malnourished people may even exposed them to severe conditions.
They were also of the view that in the absence of measures to improve general health status of the people in general and patients in particular the whole exercise might cost the exchequer dearly, while donation or funding received for the purpose might also go to waste.
As a prerequisite, it will be advisable that a mass media campaign is launched on an urgent basis to sensitize the people about improving their environments, besides adopting proper healthy and eating habits as often simple and cost-effective items are found to be of great nutritional value, doctors said. Sources in the Sindh Health Department agreed that strong dosage of antibiotics had their side-effects and the patients needed to have quality food supplements.
They, however, maintained that the latter was not an expensive option as quality food could be procured through cheap and cost-effective items.
Meanwhile, speakers at a symposium entitled: “Stop TB, Fight Poverty”, at the Aga Khan University, said thousands of people were dying of TB every year in the country because they were unable to bear the cost of its treatment.
Dr Javaid A. Khan said poverty was one of the leading factors that caused tuberculosis.
He urged the government to provide free anti-TB treatment to TB patients. NGOs and the private sector should join hands with the government in curbing the epidemic, he suggested.
Dr Majeed Memon said the stigma attached to the disease in the society should be removed as TB was a curable disease provided appropriate anti-TB treatment was given for a period of six to eight months.
“It is ironic that many women in Pakistan are divorced when their husbands and in-laws discover that they are suffering from TB,” Dr Memon said.
Dr Fayyaz Hussain highlighted the deficiency of TB study in the existing curriculum in medical colleges.
He said only 5 per cent of doctors could write the correct anti-TB drug prescription. “There are several tests that are being marketed which are though expensive, but have unproven value. Sputum microscopy remains the best test to diagnose lung TB,” he concluded.
Dr Raana Haqqee described multi-drug resistance TB as a real threat to the entire population. That type of TB did not respond to the usual anti-TB drugs.—APP