India still home to quarter of global TB cases

Despite having a strong public sector programme to contain the disease, tuberculosis still remains a cause of concern for India, which has nearly a quarter of the global burden of TB, health experts said.

Experts said measures which can help strengthen the fight against the disease include involvement of the private sector, more political commitment to create awareness and containing risk factors like malnutrition.

“TB is still a cause for concern. It is the sheer numbers in India and the associated problems like poverty which are responsible for this,” Soumya Swaminathan, director, National Institute for Research in Tuberculosis, an organization under the health ministry, told IANS.

According to the World Health Organization (WHO), there are 2.2 million tuberculosis patients in India, which makes it the world’s highest TB-burden country. TB killed 1.3 million people worldwide in 2012 and India alone accounted for 26 percent of the total cases.

She said that China and Brazil have done better in controlling TB in their respective countries and India needs to do more.

“In eight years, India has made tremendous progress as far as containing TB. But it needs to do much more,” she added.

But R. S. Gupta, deputy director general (TB) in the health and family welfare ministry, said: “Treatment success rates have been above 85 percent for several years in the country.”

Gupta told IANS that the overall quality of TB services, including human resources and systems for financial management are being strengthened.

To achieve the National Tuberculosis Programme’s (NTP) ambitious goal of universal health care access for all people with TB by 2017, financial commitments must be maintained by all partners, including international agencies, he said.

The state-run tuberculosis control initiative of the government, NTP provides free of cost, quality anti-tubercular drugs across the country. More than 1.5 million people avail the facility at 13,000 centres.

Gupta said that the private sector should be involved more as most patients are being treated in private clinics.

Agreed Swaminathan, who said that the government needs to work in tandem with the private sector.

“Standard procedures need to be followed for notification of the disease and diagnosis, especially by private practioners,” Swaminathan told IANS.

In 2012, India declared TB to be a notifiable disease. It means that with immediate effect all private doctors, caregivers and clinics treating a TB patient had to report every case to the government.

According to a recent WHO report, India has achieved the Millenium Development Goal (MDG) target for TB which says that the incidence of the disease should be falling. It is on track to reach the 2015 targets for reductions in TB prevalence and mortality.

But it added that India accounts for 31 percent of the estimated 2.9 million missed TB cases — people who were either not diagnosed or diagnosed but not reported to NTP.

It is estimated that about 40 percent of the Indian population is infected with TB bacteria, the vast majority of whom have latent rather than active TB.

Listing the other steps needed, Swaminathan said: “Getting more political commitment and activism from civil society to create awareness about TB like it was done in the case of HIV/AIDS would be a great help.”

India also needs to contain the risk factors associated with the disease. The biggest among them is malnutrition, which makes people more susceptible to the development of active TB. Tuberculosis patients have lower Body Mass Index (BMI), muscle mass and subcutaneous stores of fat.

“Malnutrition is the biggest risk factor and it has been overlooked,” she said, adding that the “disease needs to be fought on a common platform by all stakeholders.”

Source: Zee News


Malnutrition On the Rise for Children in the North

Some 100,000 children, including Nigerian refugees fleeing attacks from the extremist sect Boko Haram, are suffering from acute malnutrition in northern Cameroon. Hospitals are overwhelmed. Health officials and United Nations agencies have been visiting the children and are promising assistance.

Badyne Mansto cries as her five-year-old child is buried near her house in Maroua, northern Cameroon. She told VOA the child lost weight and died at a private hospital two hours after she was admitted. She blamed the staff for not attending to her immediately when she arrived.

Hospital staff say they are overwhelmed. Mamha Catherine is one of them.

“As you can see, there are so many patients than we can attend to. We lack infrastructure, we lack staff, so what is certain is that some of the children whose lives may have been saved will end up dying,” she said.

Dire situation

Aiida Maimonatou, who is at the hospital with her baby, is getting impatient. She said when her first child was not well, she took him to a traditional healer and he died. Now she has brought her second child to the hospital because the government is asking people not to go for traditional treatment. But, she says, “since I came here, nobody has attended to me.”

Among the malnourished children are Nigerian refugees fleeing from the Islamist militant sect Boko Haram. At their camp in Menowo in Mayo Tsanaga Division where 7,000 refugees live, more than 300 children are suffering.

Comfort Manda, who said she fled Borno State, said she has lost a child to malnutrition.

“My brother, it is very difficult. I don’t know what to tell you, but the situation that I met here is so deplorable that I don’t know what to do now,” said Manda. “I came in from Nigeria and my two children are sick, I have taken them to the hospital and find it difficult to provide their medicine. One of them already died and I am still struggling with one of them. I do not know what will happen at the end. Added to this, there is no food, there is no water and when children are sick they drink a lot of water. We are not able to have even water to give our children. It is very difficult.”

Dr. Ndansi Elvis said the crisis is aggravated because refugees have to compete with the local population for food and water.

“These people come and there is competition for food. And when there is competition for food, there is also limited supply and the prices go up. And there is the problem of early marriages. You will not expect that a 17-year-old who has a child actually understands the nutritional needs of a child as much as a mature woman,” said Elvis.

“It’s astonishing that this is a public health problem but little attention is given to it. I go through the budget of the Ministry of Public Health for this year and I don’t think that even up to 500 million CFA franc [$1 million] has been allocated for any program as far as malnutrition is concerned,” Elvis continued.

Jean Mark Eding of Doctors Without Borders said a number of factors are contributing to the increasing number of malnourished children this year.

“The first thing is the absence or insufficient food for the children,” he said. “There are also environmental factors, like droughts, floods, dykes that give way, insects that destroy crops and reduce food production.”

UNICEF says large sectors of Cameroon’s population lack access to basic health services, safe water, sanitation facilities and basic education. The agency is appealing for funds to prevent and combat malnutrition. Its officials and other United Nations agencies have been visiting the malnourished children and promising to help as soon as they get the funds.

Source: All Africa