TB in Guyana

	Public Health Strengthening in Guyana
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TB in Guyana

A consultation at the Chest Clinic with the NTP Director,

a nurse, and a Project Consultant

What is TB?

TB, or tuberculosis, is an airborne disease caused by the bacteria Mycobacterium tuberculosis. The bacteria can attack any part of the body, but usually affects the lungs. Once a leading cause of death in the "developed" world, TB is now more of a problem for the “developing” world, with 80% of incident cases occur in developing countries. Each year, 2 million people worldwide die from this curable disease.

TB in the world:

According to the WHO, someone in the world is newly infected with TB every second and, overall, one-third of the world’s population is currently infected with the TB bacillus. Five to 10% of people who are infected with TB (but not, at the same time, with HIV) become sick or infectious during their life. In 2004, an estimated 1.7 million people died from TB infections.

TB and HIV:

Together, TB and HIV form a lethal combination, each exacerbating the other’s effects, and speeding up the rate of progression. HIV weakens the immune system, thus someone who is HIV-positive and infected with TB is many times more likely to become sick with TB than someone infected with TB who is HIV-negative. TB is the leading cause of death among people who are HIV+, accounting for roughly 13% of AIDS deaths worldwide. According to the WHO, in 2000, of the 36.1 million people living with HIV/AIDS worldwide, about one-third were co-infected with TB.

TB in the Americas:

“The Americas” comprise one of the official WHO regions of health study, and include Guyana. According to the WHO, in this region in 2004:

· Incidence of TB = 41 per 100,000 (363,000 cases, 4% of the global total)

· Incidence of smear-positive TB: 18 per 100,000 (161,000 cases)

· Prevalence of TB = 53 per 100,000 (466,000 cases)

· TB Mortality Rate = 5.9 per 100,000 (52,000 cases)

TB in Guyana:

According to estimations contained in the World TB Report 2005, Guyana has the fourth highest rate of TB in the Americas, a rate of 900 new cases per year. The estimated annual rate of infection is 3.2%, and an estimated 14% of the population, or 105,000 people, are infected with TB. In 2004, 46 people died as a result of TB in Guyana, and 34 of these people were HIV+. Recent figures put the total percentage of TB patients cured at clinics in Georgetown, New Amsterdam, Linden and West Demerara at 43.7%. Overall, only 6.6% of those receiving treatment died.

PHSGP has, as one of its main objectives, the implementation of a National Program for the prevention and control of TB. This includes strengthening laboratory capacity to support the diagnosis and treatment of TB, enhancing the capacity of the NTP to provide essential TB services in Regions 3, 4, 6 and 10, and implementing, evaluating, and reviewing both National TB Guidelines and the WHO-designed DOTS Strategy in the Project regions. To date, the Project has made several important gains in the area of TB:

40 DOTS workers have been trained, 13 of these workers completed Community Health Worker training in order to have their positions subsumed by the MOH; a DOTS curriculum and training manual have also been developed
A National TB Manual has been developed and disseminated to professionals caring for TB patients around the country
The Three Annual Conferences on TB have been held in collaboration with the NTP and the Guyana Chest Society
Project consultants have provided technical assistance in the drafting of a National TB Plan for 2006 – 2011
Three TB laboratories were set up, and the central lab has the ability to perform cultures; the laboratory network is linked to a reference laboratory at CAREC, where confirmation and drug sensitivity testing are done, as well as to the National reference laboratory in Canada, where second line drug sensitivity testing is done
Several studies have been undertaken or funded by the Project; these include a study currently underway of the impact of nutritional supplements on treatment outcomes in TB patients, a study on TB and adherence, a TB defaulters study, a study of the Prevalence of MTB and resistance patterns of MTB, and a study of the Predictors of TB smears positive

Some Useful Tuberculosis Links:

Francis J Curry National Tuberculosis Center (includes online courses)

The Global Fund's AIDS, TB and Malaria projects in Guyana

WHO’s TB Publications, 2006

WHO’s Tuberculosis Site

PAHO's TB page

CDC's TB page

The Public Health Agency of Canada’s TB Prevention and Control Page

1 Nicholas Street, Suite 1105
Ottawa, Ontario,
Canada K1N 7B7
Phone: (613) 241-5785 Fax: (613) 241-3845 Email: csih@csih.org