It is not true that we have dealt with tuberculosis, and it only takes its death toll in third world countries, argued experts at the XNUMXth Conference on the occasion of the World Tuberculosis Day, which began on Friday in Warsaw.
“The tuberculosis epidemic is still on the grass. In Europe, the greatest number of cases of disease occurs in countries close to our country, such as Lithuania, Estonia, Ukraine and Our Country, ”said Paulina Miśkiewicz, director of World Health Organization offices in Poland.
Dr. Tadeusz M. Zielonka, chairman of the Warsaw-Otwock branch of the Polish Society of Lung Diseases, said that the further east of our continent, the greater the incidence of tuberculosis. It is even visible in Poland: the most cases are in Lublin, Łódź and Silesia.
Poland belongs to the European Union countries with the highest incidence of tuberculosis, but it was recalled that since World War I, the epidemiological situation in our country has changed dramatically.
In 1918, there were 100 deaths in Warsaw due to tuberculosis per 100 people. inhabitants, which put us in the first place in the world. Today there are only two deaths out of 1957. people. In 20, mostly young people fell ill, now they are almost exclusively elderly. It is rare in people aged 44-2009. And there are no more deaths among children. In 743, there were XNUMX deaths from tuberculosis, all among adults.
“In our country, there are not many cases of illness among immigrants – they account for only 0,5 percent. cases of tuberculosis “- said Dr. Zielonka. But that may change. In France, immigrants have 10 times more cases than the general population. In Norway and Sweden, as much as 85 percent. the sick are visitors from other countries.
He added that in our country prisoners suffer relatively most often. The incidence of tuberculosis among them is over 20 times higher than in our entire population.
“Men are twice as likely to be sick than women, which was not the case before. They are generally aged 50-54 “- said Prof. Ewa Augustynowicz-Kopeć from the Institute of Tuberculosis and Lung Diseases in Warsaw. In Mazovia, 10 percent. people with tuberculosis are homeless.
In Poland, there is currently no increase in the incidence of treatment-resistant tuberculosis. The so-called Only 3 percent show multi-drug resistance. all sick. However, it was emphasized that there may be more such cases in the future, as tuberculosis resistant to the most commonly used antibiotics occurs mainly in Our Country, Ukraine and China.
“It is worrying that access to some drugs for tuberculosis is difficult due to a bureaucratic procedure,” Prof. Zofia Zwolska from the organizing committee of the conference. She added that this is the first such situation in the treatment of tuberculosis in 50 years.
These are two drugs: isoniazid and ethambutol, used in non-standard therapy. There are no problems with the other most commonly used drugs – added Antoni Blachnio, director of Mazowieckie Center for the Treatment of Lung Diseases and Tuberculosis in Otwock.
Etambutol is sent free of charge for patients to the address of the clinic where the patient is treated, provided that the patient is registered in the National Tuberculosis Register.
“In Poland, 10 percent. patients with tuberculosis are not entered in the national register of this disease, which means that they are not treated, Zofia Zwolska said.
It was emphasized that the Act on Infectious Diseases and Infections did not specify what to do with a patient who persistently and maliciously refrains from treatment. And it is long and troublesome. It should last at least 180 days, with a stay in hospital in isolation – not shorter than 30 days. If a patient with advanced disease is admitted to hospital, hospital treatment may be extended up to 90 days.
Dr. Piotr Dąbrowiecki from the Military Medical Institute in Warsaw informed PAP that there were cases of escape of patients from the hospital. The facility then notifies the Sanepid, and the patient is wanted by the police and brought for treatment. Sometimes, however, after a week of therapy, the patient escapes again and everything starts all over again.
Zbigniew Wojtasiński