GCC launches assault against tuberculosis

The Ministry of Health and other GCC countries have drawn up a strategy to eradicate tuberculosis from the region by 2010. The GCC has begun the world's first regional TB elimination initiative, aiming to reduce the incidence of new cases of smear-positive or infectious pulmonary tuberculosis to one per 100,000 by 2010.

According to a ministry report obtained by Gulf News, TB still poses an important public health problem in the UAE. It is noteworthy that most of the expatriates in the UAE come from countries where TB is prevalent. "That's why the overall objective of tuberculosis control is to reduce mortality, morbidity and disease transmission as well as the prevention of drug resistance."

The report said: "In each medical district, a TB coordinator will be designated and will assume technical responsibility for programme performance. Each district will also have also a TB control team.

"All cases of TB must be reported to the Ministry. During the initial phase of treatment, infectious patients (smear positive) need hospitalisation. Also, passive case finding should be given priority over X-ray diagnosis for tuberculosis suspects attending health institutions," the report said.

It was also stated that at the community level, primary health care centres should be involved both in case finding and case holding. "Private hospitals/clinics should not treat tuberculosis cases nor prescribe anti-tuberculosis drugs. If a private practitioner suspects a case, it should be referred to the nearest public institution.

"Private pharmacies are banned from selling anti-tubercular drugs to private clinics or individuals. All close household contacts and other high-risk groups should be screened," the report mentioned.

The report mentions that the national tuberculosis programme should continuously achieve two main targets: to cure 85 per cent of detected new cases of sputum smear positive TB and to detect 70 per cent of existing cases of sputum smear-positive TB.

The report said the overall incidence of tuberculosis has increased from 18.9 cases per 100,000 in 1989 (308 cases) to 28.0 cases per 100,000 in 1998 (773 cases). The detection of 417 cases in communicable disease control centres (54 per cent of the total) among expatriates applying for residence visas accounts for the increase.

Tuberculosis detected among UAE nationals constituted 4.7 per cent of the cases reported in 1998 (37 out of 773 cases). Of the 37 cases, 65 per cent were under 45 and 13 cases were under 15. This indicates that transmission of tuberculosis bacilli is still present among the UAE national population.

The world is facing the worst epidemic of TB in history. About one-third of the world's population is infected by TB. This disease kills more youth and adults than any other single infectious agent in the world today.

The developing world is the worst affected with 95 per cent of all TB cases and 98 per cent of TB deaths. Seventy-five per cent of TB cases in developing countries are among those in their most economically productive years (15 to 45 years).

The main causes of TB are poverty and the widening gap between rich and poor, neglect which includes inadequate case detection, diagnosis and cure, changing demography which includes increasing world population and age structure, and the impact of HIV which is the most powerful factor known to increase the risk of progression from TB infection to disease.