The Relationship of Tuberculosis and Pakistan

Tuberculosis as seen on X-ray
Tuberculosis as seen on X-ray

“If Louis Mountbatten, Jawaharlal Nehru or Mahatma Gandhi had been aware in April 1947 of one extraordinary secret, the division threatening India might have been avoided. The secret was sealed onto the gray surface of a film, a film that could have upset the Indian political equation and would almost certainly have changed the course of Asian history. Yet, so precious was the secret that that film harboured that even the British CID, one of the most effective investigative agencies in the world, was ignorant of its existence. — Freedom At Midnight”

It was a dreaded illness, previously known as ‘consumption’, that is set in Pakistan’s history. It is the reason we lost the father of our nation just a year after our country came into existence. The “gray surface on a film” refers to the X rays taken that were kept in secret in the office of a Bombay physician Dr J A Patel.

Looking at this fact you would think Pakistan would be on the frontline in the fight against TB. However, despite certain measures being taken the statistics reveal a bitter reality: According to Ministry Of Health, “ Pakistan ranks 6th amongst the countries with a highest burden of TB in the world. Pakistan contributes about 44% of tuberculosis burden in the Eastern Mediterranean Region. According to WHO, the incidence of sputum positive TB cases in Pakistan is 80/100,000 per year and for all types it is 177/100,000.TB is responsible for 5.1 percent of the total national disease burden in Pakistan. The impact of TB on socio economic status is substantial”

Wikipedia defines TB as a common and in many cases lethal, infectious disease caused by various strains of mycobacteria, usually Mycobacterium tuberculosis. Tuberculosis usually attacks the lungs but can also affect other parts of the body. It is spread through the air when people who have an active MTB infection cough, sneeze, or otherwise transmit their saliva through the air. The classic symptoms are a chronic cough with blood-tinged sputum, fever, night sweats, and weight loss (the last giving rise to the formerly prevalent colloquial term “consumption”). Infection of other organs causes a wide range of symptoms. Diagnosis relies on radiology (commonly chest X-rays), a tuberculin skin test, blood tests, as well as microscopic examination and microbiological culture of bodily fluids. Treatment is difficult and requires long courses of multiple antibiotics.

It was in 1993 that WHO declared TB a global emergency. Pakistan’s NTP (National TB Control Programme) then endorsed the DOTS strategy (Directly Observed Treatment, Short Course) whose main components are:
1.Political commitment with increased and sustained financing
2. Case detection through quality-assured bacteriology
3. Standardized treatment with supervision and patient support
4.An effective drug supply and management system
5.Monitoring and evaluation system and impact measurement

However, the program became dormant due to abolition of the Federal Directorate for Tuberculosis Control in 1996. therefore the progress during the first three years (i.e. 1995 – 1998) remained slow, because (and according to NTP website) of its vertical approach, lack of consensus between federal and provincial units, and non-availability of funds from regular health budget.

Currently in Pakistan the BCG vaccine is provided to infants as a preventive measure against TB. Apart from this there is a need for preventive measures in hospitals which include using ultraviolet light to sterilize the air, special filters, and special respirators and masks. In hospitals, people with TB are isolated in special rooms with controlled ventilation and airflow until they can no longer spread tuberculosis.

2 COMMENTS

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  2. Hi. went thru the article. its well written. however, the TB statistics for Pakistan have changed due to the survey conducted in 2010-11. you may like to update the article.

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