KAMPALA, 20 March 2008 (PLUSNEWS) - Becky Mugisha* had been ill with a hacking cough for three months before she was admitted into one of Kampala's busiest tuberculosis (TB) wards, but she recognised the symptoms long before that. It was her second bout with the disease.
The last time Mugisha had had TB, about a year before, she was put on a sixth-month course of treatment. As a person living with HIV, she was used to taking multiple pills on a daily basis, but she failed to complete her treatment because the dispensing clinic where she lives in Wakiso, just east of Uganda's capital, Kampala, ran out of the drugs. Mugisha's compromised immune system and treatment history made her susceptible to infection with multi-drug resistant TB (MDR-TB), a strain of the disease that requires more expensive and extensive treatment and affects 4.4 percent of TB patients in Uganda who have previously been treated for the disease, according to the World Health Organisation (WHO). Now Mugisha is receiving inpatient treatment at the TB unit in Mulago Hospital, Kampala's main referral hospital. While many hospitals and health centres outside Kampala can treat TB, few can handle MDR-TB cases that often require long hospital stays.
JOHANNESBURG, 25 March 2008 (PLUSNEWS) - Another hospital breakout in South Africa by drug-resistant tuberculosis (TB) patients desperate to spend the holidays with their families has some public health experts questioning whether forced isolation is either the most effective or humane way to treat such patients.
On Thursday, 25 patients with multi drug-resistant (MDR) TB and eight with extensively drug-resistant(XDR) TB pushed their way past guards at Jose Pearson TB Hospital in Port Elizabeth, in the Eastern Cape. By Monday, 21 of them had returned, most of them voluntarily, four as a result of court orders.
MDR-TB is resistant to the two most powerful anti-TB drugs, while XDR-TB is resistant to these and at least two others. Whereas non-drug resistant TB is treated on an out-patient basis with a six-month course of drugs, South Africa's policy is to treat drug-resistant TB patients as in-patients until they are no longer infectious. XDR-TB patients, who are the most difficult to treat and pose the greatest public health risk, are required to spend up to two years in hospital, isolated from their families and facing the very real possibility that they will die before being released.
NAIROBI, 2 April 2008 (PLUSNEWS) -
Caption: The national referral hospital has already seen seven new cases of MDR-TB from one IDP camp in the capital, Nairobi
The threat of multi-drug resistant tuberculosis (MDR-TB) has been heightened by the displacement of an estimated 300,000 people in Kenya's recent political crisis, health workers have said.
"During the violence, many displaced people were disrupted from their lives, which meant disruption from drugs," said Dr Henderson Irimu, head of the HIV/TB treatment care at the Kenyatta National Hospital, the country's largest referral hospital. "Due to the violence it was impossible for people to come for medication."
Irimu said there had been an increase in MDR-TB, a form of the disease that does not respond to standard treatment, usually because of a failure to complete first-line treatment. When patients are co-infected with HIV, it is often lethal.
"So far we have seven new cases of MDR-TB who were brought at the hospital from Mathare internally displaced settlement [in the capital, Nairobi]," he said. "Some would come and admit to not having taken TB medication since the violence began."
"Patients who were found to have developed resistance to first line medication require to be treated in isolation for a period of four months to reduce the spread, but there is a need for a special clinic or ward facility for MDR-TB," he added.
MATANY, 27 May 2008 (PLUSNEWS) - Namoe Aisha, an HIV-positive widow with four children, is currently undergoing treatment for tuberculosis at the Matany Hospital in Moroto district, a remote region of Karamoja in northeastern Uganda. She told IRIN/PlusNews about the difficulties she has encountered since being diagnosed with the virus two years ago.
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MANILA, 4 June 2008 (IRIN) - According to the World Health Organization, the Philippines has the ninth highest number of tuberculosis cases in the world and the highest in southeast Asia. Globally, there were more than nine million new cases and about 1.7 million deaths from the disease in 2006; the WHO estimates there are more than 14 million people living with TB, which kills 75 Filipinos each day.
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DURBAN, 3 July 2008 (PLUSNEWS) - The increasing number of South Africans contracting drug-resistant tuberculosis (TB) demands a radically different approach than the current policy of isolating patients in specialised facilities for long periods. This was the message of several presentations at the first national TB conference, held in Durban this week.
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MEXICO CITY, 8 August 2008 (PLUSNEWS) - Tuberculosis (TB) is the biggest killer of people living with HIV in Africa, but only one percent of HIV-positive people accessing treatment were screened for TB in 2006, an oversight that activists say threatens to roll back the gains made in placing more than three million people on life-prolonging anti-retroviral (ARVs) treatment.
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Tianjin, People's Republic of China, 26 September 2008 - The Global Health Initiative of the World Economic Forum and The Lilly MDR-TB Partnership today launched an innovative toolkit which aims to boost the involvement of Chinese companies in tackling the TB crisis. The TB Toolkit for China is launched today at the World Economic Forum's Annual Meeting of the New Champions in Tianjin, People's Republic of China. TB remains a major concern in China, despite the Chinese government's increased commitment to tackling public health problems, including additional public health funding.
"The National TB Control Programme at the Chinese Center for Disease Control has been involved in the development of this toolkit and firmly believes that it will be an important supporting tool for businesses who are seriously thinking about tackling TB in among their workforce, their families and dependants," commented Dr. Wang Lixia, Director, National Center for TB Control and Prevention, China. She added, ''We urge businesses in China to help us tackle this public health issue marring the socioeconomic well being of the country and its people''.
In a message released today, 24 March 2009, on the occasion of World TB Day, Dr. Luis Sambo, Regional Director of the World Health Organization Regional Office for Africa has called for the "rigorous implementation of the STOP TB Strategy, including universal coverage with DOTS (the Directly Observed Treatment Short-Course)" in order to significantly improve case detection and treatment outcomes.
He said that the most important element of DOTS is a regimen consisting of a combination of first-line drugs taken, ideally, under direct observation of a health care worker. The combination is known to be very effective against active drug-susceptible TB as long as patients are compliant and complete the entire six-to-eight month course.
"We must endeavour to put every single patient on quality TB Treatment and strive to minimize patient transfers, defaults and deaths", the Regional Director said.