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Published 25 Mar, 2014 07:11am

Pakistan fifth among TB high-burden countries

LAHORE: Tuberculosis is one of the major public health problems and Pakistan is said to have the fourth highest prevalence of multi drug-resistant TB (MDR-TB) globally.

Talking to the media on the eve of the World Tuberculosis Day on Monday, Shaukat Khanum Memorial Cancer Hospital and Research Centre’s infectious disease consultant Dr Ashraf Ali Khan urged the government and the public as well to help curb the TB through maximum awareness.

The world TB Day was also observed in the provincial capital where a number of public and private sector health institutions and NGOs arranged activities to sensitise the public about the impact of the disease and its preventive measures.

“Pakistan ranks fifth amongst TB high-burden countries worldwide. It accounts for 61pc of the TB burden in the WHO Eastern Mediterranean Region,” Dr Khan said.

He said at least 420,000 new TB cases emerged every year and half of them were sputum smear positive.

Crowded living compounded by mass immigration, poverty and poor nutrition was quite challenging in developing countries. These social factors led to spread of tuberculosis, he said.

Dr Khan said tuberculosis was an infectious bacterial disease caused by mycobacterium tuberculosis, which most commonly affected the lungs.

“It is transmitted from person to person via air from throat and lungs of the people with an active respiratory disease. In healthy people, infection with mycobacterium tuberculosis often causes no symptoms since the person’s immune system acts to “wall off” the bacteria.

Symptoms of active TB of the lung are coughing, sometimes with sputum or blood, chest pain, weakness, weight loss, fever and night sweats. Tuberculosis mostly affects young adults in their most productive years.

However, all age groups are at risk. Over 95pc of cases and deaths are in developing countries. It is treatable with a six-to-nine month course of antibiotics,” he said.

He said standard anti-TB drugs had been used for decades, and resistance to medicines was growing.

“Multi drug-resistant tuberculosis (MDR-TB) is a form of TB caused by bacteria that do not respond to first-line (or standard) anti-TB drugs. The primary cause of MDR-TB is inappropriate treatment.

Inappropriate or incorrect use of anti-TB drugs, or use of poor quality medicines, can cause drug resistance in developing countries like Pakistan. Tuberculosis can be activated, if present in the dormant state in the body, by any immune-compromising illness, including cancer.

The MDR-TB is treatable and curable by using second-line drugs. However, second-line treatment options are limited and recommended medicines are not always available. The extensive chemotherapy required (up to two years of treatment) is more costly and can produce severe adverse drug reactions in patients.

People should know that TB is curable provided one is getting proper information, precise drug supervision and support from society,” Dr Ashraf Khan concluded.

Meanwhile, addressing a seminar at a local hotel, Adviser to Chief Minister on Health Khwaja Salman Rafiq said the mortality due to tuberculosis in Punjab had been reduced by 53pc which was a great success of the Punjab TB Control Programme.

The seminar was organised by Punjab TB Control Programme, Health Department.

Mr Rafiq said the mortality rate due to tuberculosis was 72 deaths out of 100,000 in 1990 which had now been reduced to 34 whereas this ratio in other countries was 45.

Punjab TB Control Porgamme Manager Dr Muhammad Naeem said that Pakistan was the fifth among 22 countries where occurrence of tuberculosis was very high.

Shalamar Hospital also organised a seminar to observe the day.

Health Director-General Dr Zahid Pervaiz said every year around 4,000 contracted the TB which was alarming. He said the Punjab government had a plan to establish a Reference Centre at Shalamar Hospital.

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