An unprecedented outbreak of tuberculosis in Papua New Guinea ;
An outbreak of multidrug-resistant tuberculosis (MDR-TB) in Papua New Guinea may well become a repeat of the answer disastrous delay pandemic West African Ebola, says Jennifer furin, medical School Harvard professor of global health and social medicine, in a commentary co-authored with Helen Cox, professor of the Division of medical Microbiology at the University of Cape Town , South Africa. The commentary was published in Lancet Respiratory Medicine March 23, coinciding with the World Tuberculosis Day, which is today, March 24.
Harvard Medical News spoke with furin to learn more about the situation in the island province of Daru, north of Australia, in the southwest Pacific.
HMN 😕 What is happening in Daru
JF: Today, on the island of Daru in Papua New Guinea, there is an important and permanent outbreak of MDR-TB. It is spreading throughout the country and possibly could move to Australia.
HMN 😕 How it compares to other outbreaks worldwide
JF: Conservative estimates indicate that 1 percent of the population of Daru is ill with multidrug-resistant tuberculosis. This translates into approximately 150 cases per year in a population of 15,000. As a point of comparison, an outbreak on the nearby island of Chuuk, one that the CDC was able to get under control, had 26 cases in a population of 108,000.
In a community in South Africa, Khayelitsha, there are about 200 cases of MDR-TB per year, with a population of about 400,000 and an HIV prevalence greater than 20 percent.
From Daru almost no HIV-which greatly increases the risk of MDR-TB cases number is even more amazing.
HMN 😕 How did things get so bad
JF: A series of factors. For example, some patients with MDR-TB Papua New Guinea who had been receiving treatment in Australia were sent back home, many of them Daru-in order to give care closer to their families.
This was well intentioned, but was limited care available in Daru. Once the infection began to spread on the island, it became difficult to stop.
Because the islanders are poor, people share often overcrowded housing 20 people in one room. In addition, there were few diagnostic services and treatment available on the island.
Although services have improved in recent years, they have not improved fast enough to keep up with the current outbreak of the disease.
Finally, health advisors and international policies to Papua New Guinea have not the leaders of health programs that help stop this outbreak advice.
HMN: You have called the outbreak of a Why use the term “time bomb.”?
JF: Because one does not realize the full devastation of the immediate event.
With tuberculosis, people can become infected with the bacteria and not get sick until months or years later.
A person with TB can cough into a room and expel the bacteria, where it will remain infectious for hours. Hundreds of people could breathe in these infectious organisms and do not know how long they have been infected.
Because the infection is not obvious, tuberculosis is much scarier than the diseases that tend to hear a lot about, like ebola, where the infection tends to lead rapidly to the development of the disease.
But when I describe the situation as if it were a ticking time bomb, I also mean that if we act to do something now, we might be able to calm the situation.
HMN 😕 What would it take to stop this disease in Papua New Guinea
JF: There needs to be a massive influx of resources-human and financial resources in the country. Although the government has created an excellent plan to stop the outbreak, which has no funds or staff to put the plan into action. And it is likely that the situation in Daru Island is also happening in other parts of the country.
large-scale urgent action now to support planning by the government. These plans include the active search for cases, rapid diagnosis and treatment with optimal therapy and prevention for those who have been exposed to pathogens measures.
HMN: Tuberculosis is a treatable disease, but still kills more than one million people each year. What does the response to this outbreak say about efforts to reach zero deaths?
JF: According to the new WHO “End TB Strategy,” we are supposed to eliminate tuberculosis in 2030, which is only 14 years away. But we do not know how to effectively eliminate tuberculosis; we have tried to control only the impact the disease has on the world’s populations.
This control strategy has been very ineffective: Tuberculosis is once again infectious disease that causes higher mortality among adults worldwide, although it is curable.
But if we are serious about ending the TB in just a decade and a half, we have to start really eliminate it. Daru would be the ideal place for this to happen, as the number of cases is manageable and the geographical location where cases are occurring is small.
However, so far there has been no real attempt to try to eliminate the disease in Daru. From global health organizations can not even commit to the elimination of multidrug-resistant tuberculosis in Daru, it is hard to believe that we will succeed in reaching zero anytime soon.
This article was originally published on medicalxpress, Read the original article
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