Health Ministry strives for 100% TB detection by 2015

Mar 30, 2011 News

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An ambitious goal of 100 percent detection rate in all regions by 2015 has been set by the Ministry of Health as part of its plan to address the scourge of tuberculosis.
This is according to Senior Health Minister, Dr Leslie Ramsammy, who also revealed that 2015 has been labelled as the year to realise reduced TB mortality.
In addition there are plans to have the incidence rate reduced to less than 60 per 100,000 persons and a 100 percent Direct Observation Therapy Strategy (DOTS) coverage rate by 2015.
These plans, according to the Minister, should also be implemented even as efforts are made to ensure that there are no increases in Multi-Drug Resistance (MDR) cases and that the adult population becomes more aware about the disease.
According to the Minister, every country now has documented cases of MDR which represents a new global challenge and a serious threat to public health.
“In Guyana we have not yet experienced a high level of MDR cases, although we have documented about five cases so far.”
However with the presence of MDR, the Minister revealed his Ministry will have to introduce greater vigilance and ensure that there is 100 percent compliance as it relates to medication among those who are being treated.
Since monitoring TB cases in 1980, Guyana has seen an increasing number of cases each year, Minister Ramsammy disclosed. He attributed this state of affairs to poor reporting, thus many cases were undiagnosed during the 1980s and early 1990s.
Although the increase continued with expanding diagnostic capacity and improved health information systems, the health sector was in a better position to tackle increased cases. As such, it was deduced that some of the cases detected were in fact due to better testing capacity and improved gathering of data.
Between 2007 and 2010, Guyana began to see a reduction in the incidence of TB, and in 2007, the rate was 93 persons per 100,000 persons in the population, according to Minister Ramsammy. This rate however dropped to 89 per 100,000 in 2010.
“The reduction appears slow, because the testing capacity and reporting have improved. Under-reporting has been reduced significantly and this is one reason why the incidence rate appears to be only slowly being reduced.”
Guyana today has an active DOTS programme where health workers go to persons with TB where they live and ensure they are taking their medicines. In 2007, about 60 percent of all TB patients were being treated through the DOTS programme. At the end of 2010, the rate had increased to 78 percent being treated through DOTS.
Just recently, renowned Pulmonologist Dr Moti Lall, during an interview with this newspaper, cited the need for more funding, and the training of health professionals as two crucial factors to aid the fight against TB.  He has for many years been directing his services to the fight against this disease which he insists remains a serious threat to the health sector.
Dr Moti Lall explained that with the occurrence of the Human Immunodeficiency Virus/Acquired Immune Deficiency Syndrome (HIV/AIDS) the scourge of the disease has intensified considerably.
“We have found that TB is a so-called by product of AIDS and what we have found also is that when most AIDS victims die, the cause of death is usually TB.”
It is for this very reason, Dr Lall said, there is an urgent need for more attention and an increase in the budgetary allocation to help combat the disease. He asserted that the disease is on the increase.
The Pulmonologist explained, too, that although a lot of approaches to combat the disease have been engaged by the health sector, such as the DOTS programme, there are still some challenges such as the failure of some patients to take their medication. “When these patients do not use their drugs, which is provided at no cost to them, they develop a multiple drug resistance and this is the creeping monster that we have to be watching for very carefully.
When these people refuse to take the drug or if they don’t get it for some reason, the disease spreads and we have a major problem. It is a problem in Europe, it is a problem in Far East Asia, and it is raising its ugly head in the Caribbean too.” This state of affairs, according to Dr Lall, could be seen as the primary reason for a decline in the success rate as it relates to the fight against the disease.
He revealed that last year’s efforts realised a mere 64 percent success rate, when in fact the aim was somewhere in the vicinity of 90 percent.
In addressing the problem, Dr Lall said that efforts are being made to even screen pregnant women to ensure that if they have TB, every precaution is taken to ensure that they do not pass it onto their unborn children. They are also screened for HIV at the same time.
The fact that some doctors who have been trained to address pulmonary conditions have been leaving are also factors hampering the desired success of the fight against TB, he added.
Dr Lall, who has spent close to four decades addressing pulmonary conditions and diseases, revealed that over the years he trained quite a few doctors, some of whom have since left the system.
“Presently we have doctors who are working with the National TB programme but who, in my opinion, should be provided with post-graduate programmes. I think more and more people should be trained, because AIDS is increasing and so is TB as a result, and we have to address this…”

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