Good job on the TB Campaign

Apr 10, 2023 Letters

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Dear Editor,

Kaieteur News – I am glad to read that “Guyana is on track to end TB by 2030.” This is ‘big’ news. Tuberculosis, or as we say, TB, worldwide, was pushed aside, because of the COVID crisis, which is still not fully over. The statistics show that COVID-19 has in fact reversed progress made in the fight against TB by over a decade. This was the natural result that defaulted from the necessary input and emphasis on the COVID pandemic, and thus, access to essential TB prevention and care services in 2020 was severely affected. Overall, globally, in 2020, an estimated 9.9 million people were ill with TB, and an estimated 1.5 million people died from TB, including 214,000 among persons living with the Human Immunodeficiency Virus (HIV).

Here in Guyana, we are on the TB trail and not taking it lightly. I read from Director of the Tuberculosis Programme, under the Health Ministry, Dr. Jeetendra Mohanlall, that there is an actual decline in the incidence rate since efforts were made to tackle TB. As I did mention, COVID derailed smooth runnings that led to the lack of the daily DOTS (Directly Observed Therapy) for patients. This means that trained health care workers or other designated individuals (excluding a family member) were not on hand to provide the prescribed TB drugs and watch the patient swallow every dose.

Dr Jeetendra Mohanlall explained that “(Although) We’re on track to end TB by 2030, we still have some challenges … We still have some struggles in Region Four where we’re not getting the full daily DOTS.” He noted that this led to some 396 new cases being detected or an incidence rate of 53 per 100,000 at the end of 2022. The thing is that the Ministry of Health is ever vigilant and aggressive, as the country actually “… made great strides over the years to reduce the incidence of TB … (as) If we reflect back to 2012 when we actually rolled out all TB services in the 10 regions for detection and treatment, we had 92 per 100,000. Over the years, we were able to reduce it.”

Another noteworthy observation, and as intimated earlier, is where c0-morbidity is a factor. This is always going to take a lot, but the country has reasons to be proud. The record shows that “Instances of Tuberculosis and HIV co-infection also existed, but this has been on the decline. (As) In 2012, the co-infection rate was 32 percent when compared to 16 in 2022.

Editor, in being realistic, Dr. Jeetendra Mohanlall explained that as “We continue to work together with our colleagues from the HIV programme. There is a lot of work to do, but over the years, we have managed to drop the burden of TB co-infection with a lot of prevention. On the note of prevention, we have new medications to introduce in the country for latent TB infection.” The Head was referring here to “A combination pill of rifapentine and isoniazid (that) will be rolled out soon to decrease the pill burden.”

Let me stitch in here that global best practices speak of what Guyana is doing. Worldwide, usually, two types of medications (rifampicin and isoniazid) are taken every day for three months. Sometimes, the treatment period is six months, with only one type of medication (isoniazid). So, we can be confident in the Director’s words which elaborated that “To treat latent TB infection currently, we’re using isoniazid daily for six months and with this combination that we will be launching soon, we will be giving the patients once a week for 12 weeks. That’s half the time and only once a week.”

In terms of geographic progress and modern technology, the news is that “Guyana has moved from one TB site in the year 2000 to now having some 21 sites across the country and five established TB clinics in the prisons.” It gets better as “Another site will be created at Soesdyke next for which staffers are being trained. The ministry had also rolled out regional testing for TB using the Gene X-pert technology that is the international method (GeneXpert is a rapid molecular test that allows the detection of M. tuberculosis and simultaneously detects resistance to the antibiotic rifampicin, all in less than two hours.)”

I remind my readers that Tuberculosis is a disease caused by germs spread between persons through the air. While it typically affects the lungs, it can also affect other parts of the body including the brain, kidneys, or spine. Despite being preventable and curable, TB remains a challenge, causing 1.5 million deaths globally every year. (G12).

The word then is ‘take no chance.’

Yours truly,

1. Singh

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• COVID, Dr Jeetendra Mohanlall, GeneXpert, HIV, Human Immunodeficiency Virus, isoniazid, programme

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