Essay on tuberculosis

Dr. Tauseefullah Akhund M.B.B.S, MPH (Sydney), (Australia)

Tuberculosis is one of the dreadful diseases affecting a number of people in developing countries including Pakistan. It is one of the most common diseases causing a high mortality and morbidity. The total number of cases is rising every year because of rapidly growing population, socio-cultural reasons, increasing number of HIV cases, a high number of Afghan refugees, increasing number of poor people and non-compliance to the treatment. Another emerging issue is widespread dissemination of multiple drug resistant cases of tuberculosis, which has raised the eyebrows of public health experts because it not only makes the disease condition more lethal, it also required very high costs to curb the condition. Pakistan, in its already not so good economic condition and reducing health costs in budgets, may not afford this. From the early 1990s Pakistan Government started Directly Observed Treatment (DOT) strategy to control tuberculosis. However, the cases of tuberculosis have continued to rise. The effectiveness of DOTS strategy has certainly put a question mark and has forced public health professionals and policy makers to revise and review it.

Tuberculosis is one of the endemic diseases in the Indian subcontinent countries from years. One third of the world’s population is infected by tuberculosis (TB) out of which 95% of cases are in developing countries (Maher, Chaulet, Spinaci and Harries, 1997, p. 13). Most people are of young age group which makes a huge impact on the productivity of less developed countries. Such a huge impact of TB in the developing countries is of great public health concern. Pakistan, in its already dooming economy can not afford to handle a huge burden of such communicable diseases.  

Tuberculosis, caused by acid fast bacteria (AFB), affects mainly lung causing symptoms like cough, fever in the evening, sweating at night and sometimes bleeding in the cough; it, sometimes, also affects several other organs like liver, kidney, skin and intestine. It spreads by the respiratory droplets and close contact with tuberculosis patients. A poor nutritional, housing and sanitation condition is responsible for TB. It is important to improve these conditions to prevent new cases of TB. Nonetheless, the most important way of preventing TB is to cure the infected patients.

In past, BCG vaccination to prevent TB was highly practiced with some success. The governments in developing countries then greatly ignored the serious consequences of this very less sensitive vaccination. Moreover, the case detection process was also slow because culture of TB bacteria took weeks before diagnosed and the X-Ray, despite being sensitive was not very specific. However, after the introduction of sputum cytology for AFB the detection of TB became very sensitive, specific and relatively easy. Also, the curative drugs became available, but none of them completely curing and required dose was for months.

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