I am stopping TB!
Posted on 24. Mar, 2009 by Ze Frollein in Health, News
24 March 2009 is World Tuberculosis Day – a day to raise awareness of a disease that we most likely associate with the past or countries far ashore. However, looking back, I remember a number of articles bringing the tuberculosis topic much closer to home. An article, published by BBC Online, reported increasing TB figures in the north east of England. An astonishing rise of 38% in TB cases was stated by the Healthcare Protection Agency and, of course, caused concern despite accompanied information that levels of the disease in the general population continue to be very low.
Whilst we are looking at approximately 8,000 new cases of tuberculosis in the UK each year, it is estimated that this number grows to nine million when considering the globe. Nearly two million people die from TB around the world every year with the highest number of deaths and mortality in the Africa Region. This makes TB the leading cause of death among curable infectious diseases.
Organised by the Stop TB Partnership, this year’s awareness day is a celebratory continuation of a two-year campaign and belongs to everyone involved in contributing to stop the disease, such as patients, doctors, nurses and researchers around the world.
It is good to see strong developments in the approach of tackling tuberculosis worldwide; with the Stop TB Partnership leading the way there seems to be hope in eventually eliminating TB as a public health problem. A comprehensive assessment of the action and resources needed to fight the global TB burden has been developed in shape of The Global Plan to Stop TB 2006 – 2015.
This year’s event raises awareness of four key areas that need addressing in order to help improve the situation worldwide:
- Drug-resistant tuberculosis is not being addressed with sufficient speed or commitment. Everyone is at risk – and action is needed now
- Across the world leaders have acknowledged the urgent need to confront the co-epidemic of HIV and tuberculosis. Now countries must take action by getting tuberculosis services to all people living with HIV and HIV services to all those affected by tuberculosis
- There are many urgent questions about tuberculosis that can only be answered through scientific investigation. We need more basic research to better understand the complex nature of the tuberculosis bacilli; translational research to turn scientific discoveries into new and better drugs, diagnostics and vaccines; and operational research to make tuberculosis services more accessible and their delivery more efficient
- Four out of ten people who become ill with tuberculosis fail to get accurate diagnosis and effective treatment. To reach them, public programmes need to form new and innovative partnerships with other groups providing tuberculosis services, like private health care providers and faith-based organizations
According to the World Health Organization (WHO), tuberculosis is an infectious bacterial disease caused by Mycobacterium tuberculosis that most commonly affects the lungs. It spreads through the air and only people who are sick with TB in their lungs are infectious. When infectious people cough, sneeze, talk or spit, they propel TB germs, known as bacilli, into the air. A person needs only to inhale a small number of these to be infected.
Left untreated, each person with active TB disease will infect on average between 10 and 15 people every year. But people infected with TB bacilli will not necessarily become sick with the disease. The immune system “walls off” the TB bacilli which, protected by a thick waxy coat, can lie dormant for years. When someone’s immune system is weakened, the chances of becoming sick are greater.
- Someone in the world is newly infected with TB bacilli every second
- Overall, one-third of the world’s population is currently infected with the TB bacillus
- 5-10% of people who are infected with TB bacilli (but who are not infected with HIV) become sick or infectious at some time during their life. People with HIV and TB infection are much more likely to develop TB
Image: World TB 2009 website
Neil Crump
28. Mar, 2009
I am interested in why there are rising cases of TB in the north east of the UK. I had a look at the BBC article and it was not clear. Dr Meng Khaw, spokesman on TB for the agency in the north east, is quoted as saying: “We know that TB affects mainly people in high risk groups including hard-to-reach communities.” I assume that by high risk / hard-to-reach group he means none native speakers, due to high levels of immigrants in the NE? Not sure if this is correct. If it is then clearly the educational communications strategy to address this needs to be health advice communicated in the languages relevant to these groups. This approach while obvious can be a real challenge. The main obstacle to address is giving the workers on the ground practical advice on how to use multi-language materials available and communicate these in a culturally sensitive way to get the best outcome. Team Aurora has experience of doing this and the results can be fantastic if delivered on the ground with the right support.
Ze Frollein
14. Apr, 2009
Reading Health Director I came across some potential answers as to why TB figures are on the rise in the UK. The journal refers to a recent study published in the BMJ which found that cases of drug resistant TB in the UK nearly doubled between 1998 and 2005. One reason for this trend is seen in the small, but significant rise in resistance to first-line treatment drugs, one of them being isoniazid. Furthermore and in line with Neil’s assumption, it was found that an ‘increasing proportion of cases occur in people who were not born in the UK and who are from certain ethnic minority groups’ which may explain the rise of TB cases in the north east of the country as well as in London. The study found that affected people had been in the UK for an average time of four years before diagnosis. Interestingly, drug resistant prevalence is also found to be higher in ‘people living in relative poverty, the homeless or illicit drug users’ who may have slipped through the surveillance databases implying even higher numbers of TB cases in urban areas such as London. This may answer the question of why, but there is still a question mark on how to deal with this issue. The authors of the study conclude with obvious actions such as ‘early case detection by HCPs, rapid testing of susceptibility to drugs, additional support services to ensure patients complete treatment as well as continuous surveillance and TB control in high-incidence areas’. I think, in line with Neil’s comment, a targeted and sensitive approach is the way forward: a multifaceted multi-language disease awareness campaign focusing on education of symptoms and a call to action is vital to address this issue. It is important to tailor messages to high incidence groups and ensure audiences are reached effectively with messages delivered in a culturally sensitive way in whatever language or whatever channel necessary.