TUBERCULOSIS: Pakistan: Tuberculosis cases on the rise

Muhammad Qasim : July 08, 2011
The primary, secondary and tertiary healthcare facilities in this region of the country have been receiving significant influx of patients with tuberculosis and the number of patients with TB being registered at the allied hospitals is continuously on the rise.
Health experts say that the number of patients with TB all across the country is on the rise and the problem is getting worse with increase in the number of cases of drug-resistant TB.
“The situation is becoming alarming as Pakistan ranks 6th among countries having drug-resistant TB,” said medical specialist at Benazir Bhutto Hospital Dr. Muhammad Haroon while talking to ‘The News’ on Thursday.
He said that Pakistan has over 170,000 registered patients of drug resistant TB while the number of unregistered patients might be many more. The number of patients with drug resistant TB being registered at the allied hospitals here in the town is continuously on the rise, however, no attention has so far been paid to the problem by the concerned government authorities.
XDR-TB is resistant to routine anti-TB drugs as well as second line drugs. The mortality rate is 80 to 88 per cent after complications and recurrence is very common and almost invariably fatal, said Dr Haroon.
He said that XDR-TB is considered as more dangerous than bio-warfare organisms like anthrax and small pox as a single patient of it is enough to kill hundreds by coughing in crowded places like public transport vehicles, offices and schools.
Studies reveal that current default rate in Pakistani TB patients is 11%, which leads to Multi-drug resistant TB (MDR-TB) and in some cases extensively drug-resistant TB (XDR-TB), which is the most dangerous form of TB with no treatment.
According to estimates, over 1.6 million suffer from TB in Pakistan; more than 410,000 new cases add up to the country’s escalating TB burden every year with prevalence of 373 cases per 100,000 population and incidence of 231per 100,000 population and the number is constantly increasing due to lack of adequate precautionary measures.

It is important that left untreated, one person with active TB might infect 10 to 15 people during one year. The delay in diagnosis, unsupervised, inappropriate and inadequate drug regimens, poor follow-up and lack of social support programme for high risk populations are some of the reasons for not reaching the target
cure rates and emergence of drug resistant forms of tuberculosis.

TB is one of the oldest diseases caused by a rod-shaped bacteria also found in the mummies of Egypt showing its ancient origin. It can affect any part of the body including brain, bones, lungs, heart, eyes and skin, said Dr Haroon.
The occurrence of XDR-TB in Pakistan has increased from 1.5 per cent in 2006, to 4.5 per cent in 2009, said Dr Haroon adding urgent measures are required to avoid exponential rise in XDR-TB. He said that the problem should be taken as a regional issue.
Associate Professor of Medicine and renowned pulmonologist at Rawalpindi Medical College Dr Nadeem Iqbal Sheikh when contacted by ‘The News’ Thursday said that the number of cases of drug resistant TB is on the rise all across the country because of lack of drugs and anti-biotic policy.

Like other hospitals of the country, the allied hospitals in the town have no anti-biotic policy that is causing rise in drug resistant diseases including TB. “Lack of rational use of drugs particularly antibiotics and anti-TB drugs are making the situation more and more alarming with the passage of every day,” said Dr Sheikh.
He said that drugs for treatment of TB are free but most of the patients do not follow the ideal protocol and leave treatment incomplete that is a major reason behind spread of drug resistant TB.
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