Globalization and the ease of movement mean that multidrug-resistant TB cannot be treated only as a Third World problem, remind international experts on the occasion of the World Tuberculosis Day.
The World Health Organization, the Global Fund to Fight HIV / AIDS, Tuberculosis and Malaria, and the Stop TB Partnership multi-drug resistant (MDR-TB for short). It is caused by mycobacteria resistant to the two main anti-tuberculosis drugs, rifampicin and isoniazid. It is most common in poor and developing countries in Africa and Asia.
MDR-TB tuberculosis is a threat to all countries because it is very difficult and expensive to treat – emphasizes prof. Michel Kazatchkine, executive director of the Global Fund. In his opinion, without the efforts put into the fight against this type of tuberculosis, good results will not be achieved, and the costs of treating the disease will continue to increase.
According to WHO data, 2009 million people fell ill with tuberculosis in 9,4, including 440. on multi-drug resistant, and 1,7 million died because of it. WHO estimates that there will be over 2011 million new cases of MDR-TB in 2015-2.
If patients with this type of disease are not treated, their risk of spreading around the world increases. We cannot allow multi-drug resistant tuberculosis to get out of control, says WHO Director General Dr. Margaret Chan.
According to dr hab. Maria Korzeniewska-Koseły from the Institute of Tuberculosis and Lung Diseases in Warsaw, tuberculosis caused by mycobacteria resistant to many drugs, including the so-called extended multi-drug resistance (XDR-TB) – i.e. resistant to two primary drugs and at least two additional drugs (quinolone and at least one parenteral drug).
This does not mean, however, that it can be underestimated. Poles travel around the world or work in the West with immigrants from poorer countries and, after returning to the country, develop tuberculosis, said the specialist at a conference organized as part of the World Tuberculosis Day.
As she assessed, there are no particularly effective methods of protection against contracting tuberculosis mycobacteria. It is best to avoid large crowds of people, and before traveling to Asia and Africa, do a tuberculin test or a more accurate test to detect the presence of mycobacteria in the body, the so-called IGRA test. The test should be repeated eight weeks after the return and if the result is positive – after tuberculosis has been excluded – undergo prophylactic therapy.
Fortunately, tuberculosis is not a highly contagious disease. In order to get infected with mycobacterium, you need to have a long and close contact with the sick person in a closed space – she emphasized. They only infect patients with pulmonary tuberculosis – when mycobacteria are present in the sputum, it takes about 8 hours, and when they are absent – about 40 hours.
The proof that everyone can contract tuberculosis, not only people from poor countries or environments at risk of exclusion, is Anna Biernat, a young Polish journalist and consultant of the Bill and Melinda Gates Foundation. In June 2009, when she was 26, she was diagnosed with tuberculosis caused by a mycobacterium resistant to one of the essential drugs. That is why my treatment lasted 10 months instead of six months – she confessed to journalists during the conference.
The first symptom of the disease was pain under the right breast. She was not properly diagnosed until two months later, because the doctors did not suspect that it might be tuberculosis. It turned out that the pain was caused by the accumulation of about 1 liter of fluid in the pleura.
Anna suspects that she contracted tuberculosis during her one-year stay in India. The disease developed a year after returning home.
I am proof that everyone can catch tuberculosis, but also that it can be cured – she said. The necessary condition for this, however, is strict adherence to medical recommendations. Unauthorized withdrawal of drugs increases the risk of developing resistant mycobacteria, so it is dangerous not only for the patient, but also for the society.
Therefore, initiatives are being taken all over the world to help reduce the spread of multi-drug resistant tuberculosis. They bring together international organizations, state and private institutions and drug companies. Activities undertaken as part of these initiatives are aimed at, inter alia, increase the availability of diagnostics and therapy for this dangerous variant of the disease and improve patient compliance.
Joanna Morga (PAP)