Over half a million people are estimated to be carrying tuberculosis (TB) in Pakistan according to the report the World Health Organization’s (WHO) Global Tuberculosis report 2016, estimated that there were 510,000 people afflicted with the disease in the country that means that 270 out of 100,000 people are affected by the TB. The WHO has ranked Pakistan fifth among tuberculosis (TB) high-burden countries worldwide, with some 510,000 registered TB cases and some 15,000 developing drug resistant TB cases every year.
TB is a leading infectious cause of death worldwide. Pakistan among the 22 high TB burden countries contributes an estimated 43 percent of the disease towards the Eastern Mediterranean region of the World Health Organization.
Pakistan is also estimated to have the fourth highest prevalence of multi-drug resistant TB (MDR-TB) globally. Whereas globally 9.6 million fall ill and 1.5 million die due to TB every year. Over 95 per cent of TB deaths occur in low and middle-income countries.
An estimated one-third of the world population is infected with TB. Someone in the world is newly infected with TB bacilli every second.
Multi-drug resistant TB (MDR-TB), extensively drug-resistant TB (XDR-TB), HIV-associated TB and weak health systems are major challenges in fight against TB.
Common in under-developed countries
TB is more common in under-developed countries where due to overpopulation, governments are unable to provide proper healthcare facilities to a large number of people. In these conditions, the bacteria easily transforms from one carrier to another. Another major reason for the increasing occurrence of TB is the lack of awareness among masses.
Undergoing the treatment is very important in this matter. The person who has TB becomes non-infectious after two weeks after the start of his treatment procedure. In efforts to reduce the happening of this disease, early treatment is very significant.
In recent years, a new concept called Directly Observed Therapy (DOT) had been introduced.
In DOT, the patient is directly observed by a healthcare visitor to take treatment and this has improved outcomes and has prevented the emergence of resistance.
Management of public sector hospitals has failed in properly implementing the Directly Observed Treatment Short Course (DOTS) to support tuberculosis patients which is mainly due to apathetic attitude of deployed medical staff.
Symptoms of disease
Main symptoms of disease are persistent cough for more than three weeks, low grade fever, coughing up blood, night sweats, loss of appetite and weight and feeling of tiredness all the time.
If somebody is diagnosed with TB, he or she should not get upset, because TB is now treatable with six months course of antibiotics.
Without proper treatment, up to two thirds of people ill with TB will die. Never leave treatment without advice of doctor. During anti-TB treatment, mother can also breastfeed her child.
Patients should not be disgraced and must receive full support from family and community. TB patient can lead an active normal life after receiving full course of treatment.
TB patient should be advised to cover his mouth while sneezing or coughing and not spit on different spots.
Newborn infants must be immunized against TB with BCG vaccine immediately after birth.
According to the relevant officials, it was earlier difficult to diagnose TB patients correctly and therefore, the subsequent improper treatment caused liver and kidney problems and hearing impairment.
Left untreated, one person with active TB will infect 10 to 15 people during one year.
The delay in diagnosis, lack of social support programme for high risk populations are some of the reasons for not reaching the target cure rates and emergence of drug resistant forms of Tuberculosis.
There are 480,000 new cases of MDR-TB each year worldwide. In Pakistan, annually approximately, 15,000 patients contract this severe form of tuberculosis; the standard antibiotics do not work anymore.
To reduce the burden of the disease in Pakistan, there is need to increase awareness among general public and especially among the youth through mass media.
TB weeks and advocacy seminars should be held to spread the message that TB is preventable and treatable.
TB is a disease of malnourished, diabetics, patients using corticosteroid drugs, drug addicts, smokers, elderly, HIV infected patients, health care workers, and alcoholics and people living in overcrowding institutions like prisons.
Tobacco use greatly increases the risk of TB disease and death. More than 20 per cent of TB cases worldwide are attributable to smoking. A person living with HIV is also about 30 times more likely to develop active TB. TB is a leading killer of HIV-positive people.
26 genexpert machines
The 26 GeneXpert machines procured by the health department have enabled the TB Control Programme to improve diagnostic services during the last one year and thus, leading to the accurate diagnosis.
Early detection of the disease
The early detection of the disease was essential to initiate the immediate infection control measures and minimize the transmission of the disease to others as one patient if left untreated could infect 10-15 people a year.
The GeneXpert was a newly-developed machine approved by the World Health Organisation (WHO) for nucleic acid amplification test, which detected the types of TB in two hours.
Tuberculosis-free country by 2030
Pakistan will become tuberculosis-free country by 2030 as the government in collaboration with global partners is making all-out efforts to eradicate the menace from the country.
Despite significant progress over the last decades regarding eradication of TB, still it continues to be a top infectious killer worldwide. The disease is claiming over 4,500 lives a day. The emergence of multi-drug-resistant TB (MDR-TB) poses a major health security threat and can risk gains made in the fight against TB.
Diagnosis centers have been established in districts of Balochistan and awareness campaigns will be launched on the emergency basis in schools and colleges regarding the disease.
The government has made a viable plan to educate doctors and paramedical staff about the disease so that they can take timely steps in diagnosing TB.
The government has allocated $500 million to eradicate the disease under a three-year plan.
The provincial governments will contribute 70 percent to the plan while the Global Fund will provide an amount of $150 million.
The government has also made legislation for collecting the data of TB patients being treated at various government and private hospitals.
Pakistan is the 5th amongst 30 high-TB countries, while 6th amongst the drug-resistant TB countries in the world. Tuberculosis is considered as one of the top 10 causes of deaths worldwide. In 2016, there were around 10.4 million new cases reported globally with a mortality of 1.7 million.
In Pakistan, during the year 2016, it was estimated that 518,000 patients were diagnosed with TB with an incidence of 268 per 100,000 populations.