Guyana records 600 new TB cases in 2005
Kaieteur News, April 29, 2006:
Just over 600 tuberculosis cases were diagnosed during last year. Of these, 40 died. However 75 percent of these deaths were as a result of the patients being co-infected with HIV/AIDS. Tuberculosis is an opportunistic infection of AIDS. Records indicate that 16 of every 100 persons are infected with the tuberculosis germ and the World Health Organisation has estimated that 800 new cases are locally diagnosed annually.
Guyana has one of the highest incidences of tuberculosis in the Caribbean and Latin America , but according to Manager of the National Tuberculosis Programme, Jeependra Mohanlall, successful strides are being made to reverse this.
One programme that has aided in this regard is the Directly Observed Therapy Short (DOTS) course. This programme was piloted in Regions One and Eight in 2003 as well as at the Georgetown Prisons. It gained momentum in 2004 when the Canadian Society for International Health (CSIH), as managers of the local Public Health Strengthening Programme, began offering its support to it.
The DOTS programme has now expanded to Regions Three, Four, Six, and Ten. The DOTS programme is a new strategy recommended by the World Health Organisation and certified by the World Bank for advancing the fight against the infectious disease. Some 25 community health workers (DOTS workers) are now directly involved in the programme facilitating daily visits to the homes of patients.
This is done as a means of ensuring that treatment is taken by patients as well as to facilitate the collection of data to developing an active database is another integral component of the DOTS programme. According to Mohanlall, through collaboration with the Global Fund, the DOTS programme will be expanding to Regions One and Five by year end as well as to the other five prisons throughout the country. He reported that with the advent of the DOTS programme more cases are being diagnosed. He informed that of the more than 600 cases diagnosed last year, more than 500 are now receiving treatment and care. Mohanlall reported that the cure rates of these patients are good.
The DOTS programme has five main components and according to Mohanlall, Government has been meeting these goals. He posited that the Central Chest Clinic is fully equipped to provide adequate treatment to patients and has been working with the National TB programme in identifying patients in need of humanitarian support.
The first component of the programme dictates that Government must have a commitment to ensure that a TB programme is established and that appropriate funding is available. All infected cases within the population should also be identified. The programme also stipulates that Government has to ensure that an adequate supply of medication is provided for the correct period of time to treat infected persons.
Testing is done by collecting sputum samples and carrying out laboratory testing to determine whether a person is infected. Mohanlall said Government has already instituted measures to establish tuberculosis programmes and treatment has remained consistent.
In addition to testing and identifying infected cases, the DOTS programme also collects data from households. Data collected for an eight-year period, 1995-2002, indicate that the prevalence rate of infection is higher among men locally.
Guyana 's initial method of treatment for persons infected with TB was solely isolation. In the 1950's, antibiotic treatment started and by 1990 the Best Sanatorium was closed. The facilities from the institution were given up in 1996. The sanatorium, although it did not provide treatment, was an effective way of preventing the spread of TB. However, with the close of the facility, by mid 1990's TB infections increased. By then, one doctor and three nurses formed part of the human resource capability of the TB section of the public health system.
Available data show that in 1990, there were 169 new cases. In 1995, the number had risen to 296 new cases, and by 2002, to 590 new cases.
The steady increase in TB cases over the years has been attributed to several factors. However the main reasons, according to the Mohanlall, are overcrowding in homes and the increase in the number of cases of persons living with HIV/AIDS. Treatment for Tuberculosis is currently being offered at the Georgetown Public Hospital Corporation (GPHC) and two communities in the North Pakaraimas .
Mohanlall also disclosed plans of launching a programme soon to treat with the stigma and discrimination of the disease. This will include working with the health education services to get health personnel to go into communities to facilitate education on the disease.
The biggest challenges to the DOTS programme , according to Mohanlall, are the inability to get persons in the various regions to manage the cases.
“We still have too small a number of professionals in the programme. We have 25 DOT workers but we need more doctors and nurses. We also need to work more in the primary health care system.”
He added that strident efforts are also being made to decentralize the unit.
Worldwide some 2 million people die annually from Tuberculosis. The daily death rate is approximately 5000. (Melanie Allicock)