The health of a nation is priceless. However, money is required to treat undermined health, and the lack of money is directly related to the growth of such terrible disease as tuberculosis (TB). Every year, between 8 million and 10 million people get infected with TB worldwide. “Poor people are usually infected with this disease,” said Myrzakhat Imanaliyev, the head of Kyrgyzstan’s National TB Center. “Those at risk include people with poor housing conditions (overcrowding, poor ventilation), who do not get proper nourishment, people with weak immunity, limited access to health services, labor migrants, the unemployed, and prisoners. Only 8-10% of the results depend on doctors, and the remaining are social conditions.”
“A severe outbreak of TB in all CIS countries was registered in the period between 1991 and 1995, following the break up of the Soviet Union. The second outbreak of the disease began in Kyrgyzstan in 2000-2001, when living conditions of the population had worsened. Today, about 80% of TB patients in Kyrgyzstan are between 15 and 50 years of age, that is to say socially active people. Many of these people are labor migrants.
A WHO representative in Kyrgyzstan, Saliya Karymbayeva, said that TB is an infectious disease caused by mycobacteria. One third of the world's population is already infected with the TB bacillus, but only one out of ten people gets infected with TB due to poor quality of life.
According to Elena Kukhranova, a representative of a program for the control of tuberculosis in Central Asia entitled “Project HOPE in Kyrgyzstan”, the incidence of tuberculosis in Kyrgyzstan in 2010 was 97.4 cases per 100,000 people, and in 2011 — 96.2 cases were registered (including prisoners – 101.6). In 2010, the mortality caused by TB was 8.6 cases per 100,000 people, and in 2011 — 8.8 cases (including prisoners – 9.2). This is a very high rate even though it does not show the real picture, because many people do not go to medical institutions.
Karymbayeva said: “Kyrgyzstan, under the aegis of the World Health Organization (WHO), has adopted a TB treatment strategy and for the past 20 years the country has been receiving expensive donor drugs: $3,000 is required to provide treatment for one normal TB patient, and up to $5,000 are required to treat one patient with drug-resistant TB. It is a danger that the number of patients with drug-resistant TB, which is very difficult to treat, is increasing in Kyrgyzstan. According to recent data, the incidence of drug-resistant TB is 26% of new cases and 52% among previously treated cases.”
“Kyrgyzstan is unable to provide treatment for TB patients without the donor assistance, but it can and should take preventive measures,” said Marat Kaliyev, Deputy Health Minister. “It is important to tell uneducated people living in the countryside, where 99% of the population are TB infected, about the ways the disease is transmitted (a TB causative agent spreads through the air by coughing, sneezing, loud conversation), where to go if you think you are infected, about the dangers of exposure, consequences of poor sanitation at home, and about the balanced diet. It is important to identify the disease at an early stage when the treatment is much cheaper, and thus block the spread of infection, because one patient with active tuberculosis without treatment can infect 10-15 people per year.”
The United States Agency for International Development (USAID) has joined the fight against TB in Kyrgyzstan. The head of the USAID representative office in Kyrgyzstan, Carey Gordon, said: “Over the past decades, tuberculosis remains one of the relevant issues for Kyrgyzstan’s healthcare for many reasons, including socio-economic issues, and because of poorly established TB detection and treatment in the country. To reduce the incidence and mortality from tuberculosis in Kyrgyzstan, including the drug-resistant form, it is necessary to pay special attention to implementing evidence-based standards of medical care at all levels of the healthcare system. Since 2012, Kyrgyzstan has started to introduce WHO recommendations on TB control. One example is the pilot project ‘Outpatient treatment of TB patients’, which is being implemented with the support of USAID Quality Healthcare project. USAID has purchased diagnosis equipment which helps to test patients just for a few hours instead of two months. A series of workshops were organized, and 211 health workers were trained.
Barton Smith, a regional representative of the Quality Healthcare project, said: “Since April 2012, the project has been collaborating with medical institutions of the Issyk-Ata district, selected by the Ministry of Health as a pilot project to improve diagnosis and treatment of tuberculosis patients, with the technical support from USAID. Today there are significant results of the implementation of WHO recommended measures to reduce the spread of the disease. The pilot project has shown that without a large financial investment, you can create a safe environment for visitors of medical facilities.”
Minera Ibragimova, a phthisiatrician of the Issyk-Ata district, believes that the project has proved the important role of medical personnel who are the first who deal with patients. It is possible to reduce the spread of TB through giving questionnaires to patients who are waiting in the hallway for their turn, revealing patients with respiratory symptoms, creating separate rooms for the collection of phlegm for those who have long been coughing, and by improving ventilation in medical facilities.
In 2013 the Ministry of Health aims to implement this successful pilot project in other regions of the country.
Source: The Times of Central Asia