Three Million To Die
Of TB This Year
By Andrew Dube
Times of Zambia
Lusaka - One hundred and seventeen years ago, Dr Robert Koch, discovered the virus that causes Tuberculosis.
This brightened hopes for a TB cure. But today, the disease is killing millions of people every year. This year, between 2-3 million people will die due to TB.
According to WHO, this figure will record the highest number of deaths from Tuberculosis (TB) in history. Experts further say that this will result in hundreds of thousands of children, throughout the world, being orphaned .
By 1996, Zambia had more than 40,000 people infected with the TB bacilli. The 1998 WHO statistics further revealed that the country was leading in TB cases in southern Africa.
Due to the country's rising numbers of TB patients and those likely to be infected, Health Minister, Professor Nkandu Luo, in her speech read on this year's World TB day, said government had declared TB a national emmergency: needing all the attention it can amass both from the general public and the government Experts assert that TB's infection rate is so high that an infected person could infect 10-15 people in a year. This is certainly to force poor governments, Zambia included, to outstretch their already limited resources with a view to bring the disease under control. TB/ Leprosy national coordinator, Moffat Malukutu says the problem of TB is no longer a hospital or clinic problem, but " a problem for everyone." According to Malukutu, the fight against the tuberculosis, should not be left to the government alone, but that the local communities should complement governments efforts by working together with their healthy centres, to ensure the rapid spread of the disease is forestalled.
One effective way, which has been identified to treat the disease is called DOTS - Directly Observed Treatment, Short-course. This WHO initiative combines several elements namely Political commitment, Case detection through smear microscopy, directly observed short-course treatment regular drug supply and monitoring systems.
However logistic problems have affected the smooth running of DOTS around the world such as irregular supply of TB drugs. TB patients around Zambia, have had to make do with limited supply of the required drugs, for the eight-month-long TB treatment, due to lack of proper communication between health centres and the Central Board of Health. However, Dr Webby Mwape, executive Director of the Community Based Tuberculosis Organisation (CBTO), has said in the past that the tendency to give one drug to TB patients gives rise to the dreaded Multi-drug resistance-TB, a complex type of TBresistant to medication.
This increases fatalities from TB. Mr. Malukutu says district health management teams need to ensure that the Central Board Of Health (CBOH) is quickly notified about the lack of drugs to avoid recurrence of the disease. The other problem hounding DOTS efforts, is the over whelming number of TB patients compared to the few healthy workers available to ensure patients swallow their medicine.
Most patients have a tendency of stopping taking the curative drugs once they start feeling much better, or the unpleasant side-effects begin to afflict them. This increases chances of one developing the fatal MDR-TB.
This, therefore, increases the need for close monitoring of patients by a relative, a friend or a health worker." We should not leave monitoring of patients, to the out-numbered health workers only, each of us has a role to play to combat the disease, relatives and friends should ensure that patients systematically take their medicines despite the side effects of the drugs," Dr Alwyn Mwiinga said. However, strict adherence to the treatment of the disease without an equal attention to preventative efforts will yield but little.
The 1998 WHO fact sheet on TB says: "TB is indeed a challenging disease needing more research. . ...our immediate problem (should) is to control it in our communities and know the best ways of preventing it" It is therefore, a fallacy to claim that since the air we breathe is already contaminated by TB germs it would be worthless to mount efforts to prevent the disease. The community can help prevent more infections by advising patients and non-patients to use a sputum bottle rather than spluttering diseased saliva into the air or the ground as well as other public places.
"TB can be transmitted by careless people- men and women-who spit on the floor, public places (sports fields), walks or paths. Mixed with dust, some of the germs may be blown about and breathed in by passers-by or carried into one's home on the sole of the shoes" Your Medical Guide It further says children may get the germ by playing in such places and soiling their hands and mouths, eventually transmitting the virus far and wide. Another common way through which the germ can be transmitted is by one putting another person's saliva-smeared pen or whistle in to one's mouth or chewing a TB infected bow-point tip.
It is better to prevent the illness by applying strict caution in what goes in to one's mouth and lungs. Full nights of prayer against demons of Multi-drug resistance-TB contacted due to one's own negligence of preventative measures will not be of any benefit except to dishonour the author and inspirer of these biblical words: "Ye shall reap just what you sow ." (Galatians 6:7) And one other way through which Tuberculosis is transmitted buying is infected meat and milk.
Most people care less about where they get their meat and milk- as long as it looks good . Whether it is from an uncertified meat seller along that dusty road or at a dubiously run abattoir in the township- coming to life only in the early hours of the morning.
One wonders why they only work under the shadow of darkness- carcass-laden vans only appear when every one, including road block police officers- is fast asleep. Very suspect.
Isn't it? Lusaka City Council health inspector, Chanda Bwalya, says:" It must be remembered that a risk of TB infection does exist from the ingestion of specifically infected (animal) organs or and the meat of a carcass affected with Tuberculosis. "The best way to prevent buying infected meat, is to get one's meat supplies from certified butcheries subjected to stringent and constant health checks," says Mr. Bwalya.
This is so because some cattle owners slaughter sick animals for sale to the urban areas with absolutely no qualms about what harm it will do to citizens . If the cow has TB, the germs may affect the milk too.
"Boiling the milk at 145 F(63C) for half an hour or heating it at 160F (71C) for half a minute will kill all the TB germs present. It is better to prevent the spread of this deadly disease than to let it prevent many who are could have contributed to the welfare of the nation due to TB.