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| Sunday, 9 June 2002 |
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| News Business Features Editorial
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Combating TB thro' DOTS program by Don Asoka Wijewardena Tuberculosis is one of the most widespread killers with an annual world death rate of 3 million people despite known effective treatment, the cost of which is relatively low. In Sri Lanka, about 8,000 people are afflicted with Tuberculosis annually with a death rate of 400 people. Tuberculosis is the leading infectious killer of AIDS victims, among whom women are the most. It even exceeds the death rate among women and other causes of maternal mortality. If the current trends continue, at least 30 million people would die of TB during the next 10 years. Excerpts of the interview the "Sunday Observer" has had with Dr. Kapila Sooriyarchchi, Acting Director of the National Program for Tuberculosis and Chest Diseases on the eradication and treatment of TB in Sri Lanka, are as follows: Q. Since 1999 more and more people have been suffering from TB in Sri Lanka despite effective treatment. What is the main cause for it? A. Before 1999, about 7,000 TB cases were detected annually but since the end of 1999,there has been a dramatic increase of TB patients. The root cause of this increase is that most people who contract this disease do not follow medical advice and treatment. Most TB patients are poverty stricken and neglect prescribed treatment at the right time. Another factor is that TB patients stop taking medication soon after they feel better. Q. How does TB spread and can it be cured? A. TB is a communicable disease which can be cured.It is mainly communicated through droplets sneezed or coughed into the air by people afflicted with the disease. Poor treatment can be worse than no treatment because it fosters the development of drug-resistant strains of TB. Q. Has the Ministry of Health introduced effective treatment to combat TB in Sri Lanka? A. Yes.All over the world including Sri Lanka, Directly Observed Treatment Shortcourse (DOTS) has been implemented to combat the disease. Under this treatment TB patients are required to take medicine under watchful eyes of health personnel for six months and, up to 90 per cent of TB victims, can be cured by this treatment. The Ministry of Health spends nearly Rs. 2,500 per patient for this treatment. Q. What are the symptoms of this disease and is the DOTS program implemented throughout the country? A. When a person contracts TB he or she develops a cough,chest pain, slight fever, loss of appetite and chest haemoptysis (blood-stained sputum). Doctors are able to diagnose TB through sputum microscopy very easily. At the moment the DOTS program is implemented in 13 districts at MOH offices and we expect to make this treatment available in all the districts at the end of 2003. Q. What was the response of patients since the introduction of the DOTS program? A. The response has been really encouraging and the patients have to take medication in the presence of a health worker. The health workers have been instructed to educate patients on the effectiveness of this treatment, which fully cured has a large number of fully cured patients. Q. How many TB clinics are there in Sri Lanka and what is the average detection of TB cases? A. There are 22 TB (chest) clinics and about 20 to 25 cases are detected for a day. The problem is that some patients have developed Multi Drug-Resistant Tuberculosis (MDRTB) due to long neglect of taking medication. Colombo and Gampaha have recorded the highest number of TB cases in the country. Q. What are the future strategies formulated to combat the disease? A. We are planning to introduce educational programs for doctors in the private sector because some of them are not aware of the modern treatment. We are grateful to the World Bank (WB), Global Fund (GF) and the World Health Organisation (WHO) for boosting their budgets for the eradication of TB, especially in the South Asian countries. We are also planning to open more chest clinics and introduce massive mass communication programs through state media to educate the general public on the prevention and eradication of TB. What is needed is an effective strategy to deal with the reappearance of the disease. Microbacterium Tuberculosis can be cured in more than 90 per cent of the cases with a combination of two to four drugs and, in some of those cases, patients would remain infected by the most resistant form of the tuberculosis bacillus, which can contaminate other people. |
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