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Tuberculosis a disease affecting individuals and communities economically as well as physically Dr. Tauseefullah Akhund M.B.B.S, MPH (Sydney), (Australia) October 20, 2004
It is common misunderstanding that infectious disease has been eradicated from the world. Infectious diseases are still major threat to the world, especially tuberculosis is a main cause of death among infectious diseases.
Tuberculosis is now spreading to the most prosperous and wealthiest cities of the world, irrespective of rich or poor.
The disease can be detected and treated effectively by identifying People who are having cough, lasting for more then two weeks, with weight loss, night sweats, and evening rise of temperature.
It is estimated that tuberculosis is affecting nearly two billion people in the world, and of those, eight million are having active form of the disease. About two million people die each year from tuberculosis. Tuberculosis affects mostly people who are living in poverty, overcrowded conditions, and economically unstable, homeless people.
The disease is a major obstacle in achieving economic and social development, because it affects patients in their economically productive age. It is been estimated that people who incur this disease loose their nearly 20-30% annual income and if death results 15 year income, due to inability to work.
Adding to the crisis tuberculosis has emerged as resistant to multiple drugs, and it is considered as serious public health threat. Resistance has been attributed partly due to breakdown in health infrastructure such as, crowding, immigration, and homelessness, co-infection with HIV and due to non compliance with therapy.
New strains of mycobacterium tuberculosis resistant to standard anti tuberculosis drugs are spreading through out the world, making eradication of tuberculosis difficult. It can take time up to two years and $ 250,000 to be eradicated.
According to World Health Organization (WHO), people who live in central Asia and Eastern Europe are ten times more at risk of developing drug resistance then the rest of world.
The main aim of tuberculosis control is to cure the patient from disease and also to reduce the chances of transmission of disease to others in the community. Chemotherapy is the most powerful tool in TB control. It carries individual benefits by reducing both morbidity and mortality.
Prophylactic treatment is also necessary for immediate contacts of patients or people who are at risk. Bacillus Calmette Guerin (BCG) vaccination is used to provide substantial protection especially in infants. BCG vaccination is mandatory in regions where disease is endemic.
There are certain intervention strategies applied to control this deadly disease, like WHO funded Directly Observed Treatment Short course (DOTS) program worldwide. DOTS is cornerstone in patient centered approach to treatment to maximize the likelihood of completion of therapy.
DOTS is based on certain key components like, it provides reliable supply of free anti-TB drugs for at least six months, helping governments to diagnose and control the disease, and standardized recording and reporting system.
WHO funded DOTS program is now treating nearly three million TB patients each year, with an increase of over 1 million people each year.
To eradicate tuberculosis is a global challenge, and for that community should take active part in it.
Finally, efficient prevention and elimination of tuberculosis from this world is only possible by combining modern sciences, effective public health measures and strong commitment of international community at all levels.
REFERENCES Arias, C. D. (2004). TB remains a formidable foe despite global health advances. The Nation’s Health Washington, 34(4), 21-21.
Jasmer, M.R., Seaman, B.C., Gonzalez., C.L., Kawamura., M.L, et al. (2004). Tuberculosis treatment outcomes: Directly observed therapy compared with self-administered therapy. American Journal of Respiratory and Critical Care Medicine. New York, 170(5), 561-566.
Lawrence, J. & May, D. (2003). Infection Control in the Community. London: Churchill Livingstone.
Paredes, C. F. (2004). The return of the white plague: global poverty and the new tuberculosis. JAMA, Chicago, 291(21), 2646-2648.
Porter, H.D.J., Mcadam, J.W.P.K. (1994). Tuberculosis Back to the Future. England: John Wiley & sons.
Ravigilione, C.M.., Pio, A. (2002). Evolution of WHO policies for tuberculosis control, 1948-2001. The Lancet London, 359, (9308) Mcmichael, T. (2001). Human Frontiers, Environments and Disease. United Kingdom: Cambridge University Press.
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