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Yes we can end TB
Editorial…
Kaieteur News- Yesterday was World TB Day, observed under the theme: Yes! We Can End TB: Commit, Invest, Deliver.
According to the World Health Organization (WHO) World TB Day observed annually on March 24, amplifies the urgency of ending tuberculosis—the world’s deadliest infectious disease. According to the WHO TB continues to devastate millions globally, inflicting severe health, social, and economic consequences.
However, despite long dreaded as a killer disease, we want to emphasise that TB is curable – and has been since the 1940s – but that it remains a scourge primarily due to a lack of discipline in those who are infected to maintain the prescribed regimen of treatment.
World TB Day is observed each year on March 24 also to commemorate the date in 1882 when Dr. Robert Koch announced the discovery of Mycobacterium tuberculosis (MT), the bacterium that causes tuberculosis (TB).
Spread from breathing-in air contaminated by bacteria exhaled by patients, the infection rate is extremely high.
With the WHO estimating that each day, close to 3425 people lose their lives to TB and close to 30,000 people fall ill with this preventable and curable disease. However, the organisation said that global efforts to combat TB have saved an estimated 79 million lives since the year 2000.
In its latest Global Tuberculosis Report, WHO highlighted that more than 8.2 million people with TB received access to diagnosis and treatment in 2023 up from 7.5 million in 2022 and far above the levels of 5.8 million in 2020 and 6.4 million in 2021. There is still a large global gap between the estimated number of people who fell ill with TB and the number of people newly diagnosed.
In the early days after Koch’s discovery, isolation of patients in “Sanatoriums” became the standard treatment until 1943 when the antibiotic streptomycin was discovered. Today, the drugs used in the fight against TB are Isoniazid (INH), Rifampin (RMP), Pyrazinamide (PZA), Ethambutol (EMP), and the old standby Streptomycin (STREP). During treatment, a patient will take a combination of these drugs because the TB bacteria may be resistant to one or more of the drugs. It is only through the use of multiple kinds of antibiotics that you can be sure to kill every bacterial cell.
These short-course anti-tuberculosis drugs are normally prescribed for a period between six and eight months. It is critical to take the prescribed amount of each at the prescribed intervals, and for the prescribed length of time. If a patient takes the drugs for the full length of time prescribed by the doctor, he/she will be cured.
But herein lays the problem: most patients give up after two to three months. The MT, as a living creature, adapts to its environment by mutating and the resultant strains become immune to the drugs. The disease is said to be Multi-Drug Resistant TB (MDR-TB) when it is resistant to at least two of the first line drugs used: Rifampicin and Isoniazid.
The Directly Observed Therapy Short-Course (DOTS) strategy was introduced worldwide in the 1990s to overcome the problem of patients not taking their medicine as prescribed. In this simple but tedious process, the ingestion of every dose of medication is directly observed. And this is where if everyone connected with TB patients supports the health workers in charge of DOTS to ensure patient compliance, the disease would be drastically reduced.
So, in this season when we shine the spotlight on TB, we have been reassured by the Ministry of Health that Guyana has made significant progress in reducing the number of tuberculosis cases in recent years and is well on its way to eradicating TB as a public health concern by 2030. The ministry has also acknowledged that collaboration and coordination among all stakeholders, including patients, community leaders, DOTS workers, and healthcare professionals, are essential to ensure that all efforts are aligned. Like this year’s theme, it must be the collective resolve of everyone that, yes, we can, end TB.
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