Understanding the Prevalence of Tuberculosis and the Effectiveness of Intervention Programs - Essay Example

Tuberculosis Many people have the notion that tuberculosis, commonly termed as TB, has been put under control. However, it has re-emerged as a major global health problem. To highlight the magnitude of this disease, over 30% of the world’s population has contracted the TB bacterium, Mycobacterium tuberculosis or Mycobacterium bovis. To aid in understanding the prevalence of this disease and the effectiveness of intervention programs, this paper discusses the epidemiology and risk pattern as well as evaluates current national and international health programs to combat TB. Epidemiology and Risk Pattern Based on a study conducted by the World Health Organization (WHO), around two billion people get the TB bacterium. However, not all develop the full-blown disease. Nevertheless, the incidence rate is still within the high level as an estimated eight million people become infected with TB and 25% of them die annually (National Institute of Allergy and Infectious Disease 2005). Note that the incidence rate of TB varies across countries. However, the disease is much more prevalent in developing countries than in advanced economies. To illustrate this fact, according to the WHO Report (Global Tuberculosis Control 2006), South Africa posted the highest incidence of TB with 718 cases per 100,000 people in 2004. Similarly, India reported over 1.8 million TB cases in the same period. China and Brazil also had relatively higher incidence rate with 113 cases and 64 cases for every 100,000 persons, respectively. On the other hand, lower TB incidence rate is observed in developed countries. For instance, in the United Kingdom, TB incidences range from 40 per 100,000 in London to less than 5 cases per 100,000 in the rural South West of England (Stop TB Partnership 2002). The same trend is seen in Western Europe with Portugal at 42 cases per 100,000 persons and Spain with about 20 persons per 100,000. Likewise, the United States has an overall TB case rate of only 5 per 100,000 persons in 2004 (Center for Disease Control 2005). In terms of age, WHO (Global Tuberculosis Control 2007) examined the notification trends globally and found out that fall in case rates among adults aged 35 to 64 year olds. However, an uptrend is seen among 15 to 24 year olds. Alternatively, it may also be seen that the average age of TB patients is sliding among younger adults while the number is climbing among the elderly. The difference in pattern is exhibited by Bangladesh, China, Myanmar, Sri Lanka and Thailand. Another trend is seen in Indonesia with the average age of older and younger TB patients falling. In the US, the average age is falling among younger patients while there are no apparent increases among older patient population (Global Tuberculosis Control 2007) On the aspect of gender, TB remains to be one of the leading causes of death among women of reproductive age, although there are some countries like Morocco where the cases of TB in men are increasing (Stop TB Partnership 2002). As for other risk factors, smoking more than twenty cigarettes daily is said to increase the risk of TB by two- to four times (Davis, Yew, Ganguly, et al 2006). Apart from this, there are also cases wherein TB is contracted due to the weakening of immune systems due to the use of immunosuppressive drugs, substance abuse and HIV or AIDS (Global Tuberculosis Control 2006) In view of the discussion above, it can be seen that data available may not be sufficiently powerful or still incomplete to fully determine the pattern of TB globally. However, the data highly suggest that the epidemiology of the disease among young men and women could be instrumental in controlling the spread of the disease in developed countries as well as in Asian nations with high incidence rates (Global Tuberculosis Control 2007) Effectiveness of National and International Health Promotion Interventions Program Incidence of TB has substantially declined from the period health authorities recognized the re-emergence of the disease. Despite the significant reduction in prevalence and death rates, cases are not yet falling at a sufficient rate to achieve the targets set by WHO by 2015 (Global Tuberculosis Control 2007). In this regard, improvements in both national and international health programs to fight TB may still be considered and eventually undertaken. In the local front, the Center for Disease Control has been focusing its efforts on screening and monitoring of foreign residents born or raised in countries with high TB incidence rates as well as those with lifestyle that makes them prone to TB. I believe that such preventive measures are a good starting point. However, rather than just targeting particular groups, it may opt to also focus on respective communities to which these people belong as the disease is highly contagious. This may also help further drive down the incidence rate in the US. On the global front, WHO, upon its declaration of TB as a global health emergency in 1993, has implemented its global plan to stop tuberculosis along with STOP TB Partnership. As mentioned, the organization doubts if it could achieve its objective of saving fourteen million lives until 2015 at the current rate of decline in TB cases. The international health agency has devised the Stop TB Strategy to attain its goals. In 2005, the Directly Observed Treatments (DOTS), which underpins the Stop TB Strategy, is being implemented in almost 187 countries. In spite of the wide expanse of the program, problems that challenge its effectiveness persist. For example, there seems to be a shortage in skilled and highly motivated staff since retaining competent workers is extra-challenging when general medical personnel are already overstretched. Despite this situation, the organization noted the highly variable quality of human resource development particularly for TB control programs. Some countries with a greater need for comprehensive training had training programs which are limited in scope (Global Tuberculosis Control 2007). Moreover, problems with the reliability of drug supplies and laboratories are being encountered in various WHO regions. There are reports on frequent drug stock-outs, too few laboratories and weak quality control. In addition, there are some regions which are implementing TB programs not completely in line with Stop TB programs (Global Tuberculosis Control 2007) Given these challenges, international TB programs may still be enhanced to make the 2015 target attainable. One of the major improvements identified is for WHO to forge stronger partnerships with local health officials especially within countries posting high incidence rate. As such, there would be more effective coordination and wider dissemination of information. Furthermore, both local and international health authorities would be able to assist each other in sourcing greater funding for TB programs. This would be required for conducting more effective training programs for medical personnel and for ensuring the steady drug supply and quality of treatment particularly in developing nations. Works Cited Center for Disease Control, 2005. Tuberculosis. Available from: www.cdcnpin/scripts/TB/eliminate.asp [10 April 2007]. Davies PDO, Yew WW, Ganguly D, et al, 2006. “Smoking and tuberculosis: the epidemiological association and pathogenesis”. Trans R Soc Trop Med Hyg, 100:291-8 National Institute of Allergy and Infectious Diseases, 2005. Microbes in Sickness and in Health. Available from: www.niaid.nih.gov/publications/microbes.htm [10 April 2007]. Stop TB Partnership, 2002. “London tuberculosis rates now at Third World proportions”. [PR Newswire Europe Ltd.]. Available from: www.prnewswire.co.uk/cgi/news/release?id=95088 [10 April 2007]. World Health Organization, 2006 and 2007. GlobalTuberculosis Control. Available from: www.who.int/tb/publications/global_report/en/index.html [10 April 2007]. Read More