Tuberculosis eradication: awareness is key

There was hope and expectation that this disease, Tuberculosis, or TB as it is commonly called, would have been eradicated by the turn of the century. However this has not been the case and we still see cases of TB here in Phuket.

TB causes a chronic or long term infection, usually in the lung and is spread from person to person through the air, usually by coughing, sneezes or living in close proximity to others.

TB causes a chronic cough, and patients may even cough up blood. Chest pain, weakness weight loss, lack of appetite, chills, fever, and night sweats are common. It is also claimed that immigrants have a higher likelihood of either having the disease, or being able to transfer TB to others.

TB infection is either active or latent. In case of active TB, it literally means that symptoms are present and the infection is contagious, meaning you can pass it on to others.

Simple tests can be done to confirm that someone has active TB, usually a small skin test and or a chest x-ray. Sputum can also be tested.

Latent TB means that the organisms have infected a person, but they are not showing any symptoms of the disease. Many people have latent TB, and latent TB is not usually found unless your doctor is looking for it, such as when applying for certain visas to countries like Australia which may require a medical clearance.

Latent TB can progress to Active TB.

There is no typical person who may get TB, but those with diabetes, chronic renal disease, drug users, HIV patients, patients taking immunosuppressive medications, and patients with certain cancers have a higher risk.

Generally these groups of people have a lowered immunity to TB and are therefore at greater risk. This is also the reason why Thailand has seen an increase in the number of TB infections during the 1990’s, as it correlates with an increase in HIV infections.

One of the problems that Thailand faces in its fight against TB is Multiple Drug Resistant TB (MDR TB).

This category of the disease is resistant to two of the front line drugs which are usually used to treat TB. However, the prevalence of MDR TB is low in Phuket and much higher on Thailand’s border regions. The problem with MDR TB and why it is increasingly becoming a problem is because of poor compliance with patients taking medication.

TB is treatable, but it usually takes up to 9 months using a range of different antibiotics and patient compliance is essential to eradicate the disease.

Some patients do not take their medication regularly, or cease taking it altogether. This gives time for the TB to become resistant to the antibiotic medication, so patient education and compliance with treatment regimes is essential if TB is to be eradicated.

Once TB becomes multiple drug resistant, treatment may take up to 18 months, with many second line antibiotics being used, and there is a considerable increase in the cost of this treatment.

Treatment of TB is effective, as long as the doctor’s orders are followed and medication taken properly. If you have a persistent cough that will not go away, are feeling tired, weak, are losing weight or have other symptoms mentioned in this article, see your doctor and take their advice.

Peter Davison is the Manager International Services at Phuket International Hospital. Questions or comments may be sent by email to peter@phuket-inter-hospital.co.th or by fax to 076 210936