TB cases in Phl declining – WHO

MANILA, Philippines - The number of tuberculosis cases in the Philippines and three other countries in Western Pacific has declined in the last 21 years, boosting the region’s efforts to meet the target to halve TB epidemic by 2015.

The World Health Organization (WHO) noted in its Global Tuberculosis Report 2012 that the number of TB cases in the Philippines, China, Cambodia and Vietnam had been going down from 1990 to 2011.

These four countries accounted for 93 percent of TB cases in the Western Pacific region, and are also among the 22 “high-burden” countries for TB epidemic, which accounted for more than 80 percent of global cases.

“Since 1990, Cambodia has seen a 59 percent decrease in TB deaths and a 51 percent decrease in the number of people with TB. Over the same period, China’s TB deaths decreased by 81 percent, while the number of Chinese with TB decreased by 52 percent,” the report said.

In the Philippines, TB deaths went down by 49 percent while the number of Filipinos with TB decreased by 52 percent.

In Vietnam, the number of deaths decreased by 27 percent while the number of Vietnamese who contracted the disease declined by 20 percent since 1990.

WHO said that Western Pacific is on track to achieve the Millennium Development Goal (MDG) target as cases also decreased in the region from an estimated 21 per 100,000 of population in 1990 to 6.9 per 100,000 of population in 2011.

During the same period, the number of people with TB had gone down from 255 per 100,000 of population to 138 per 100,000 of population.

The number of new TB cases, on the other hand, decreased from 159 per 100,000 of population in 1990 to 92 per 100,000 of population in 2011.

“These milestones validate the strong efforts made by governments and dedicated health workers with consistent technical support from WHO,” said WHO regional director for Western Pacific Shin Young-soo.

Shin added that the governments’ “diligence, dedication and proficiency have saved millions of lives.”

But he cautioned against complacency, emphasizing that “countries need to strengthen their health systems to prevent the development and spread of TB, especially multidrug-resistant TB (MDR-TB).”

The report also highlights the success of Cambodia. Twenty years ago, the country had one of the world’s highest TB rates and a health system “weakened by decades of conflict and economic hardship.”

“Over the past decade, universal access to TB care through primary health centers has halved the number of new cases and helped Cambodia meet global targets for detection and treatment,” the report said.

At the core of Cambodia’s approach was the WHO-recommended Directly Observed Therapy-Short Course (DOTS) strategy, “with its emphasis on supporting TB patients as they follow a six-month treatment regimen.”

The strategy is a five-component package comprising political commitment, diagnosis using sputum smear microscopy, a regular supply of first-line anti-TB drugs, short-course chemotherapy, and a system for recording the number of cases detected by national TB control programs and the outcomes of treatment.

The report also shows that between 1995 and 2011, 51 million people worldwide were successfully treated for TB in countries that had adopted this strategy. This saved 20 million lives.

But the report emphasized that MDR-TB continues to be a threat to efforts to control TB.

“MDR-TB is TB that does not respond to at least isoniazid and rifampicin, the two most powerful tuberculosis drugs. The primary cause of multidrug resistance is mismanagement of TB treatment,” the report pointed out.

Most people with TB are cured by strictly following a six-month drug regimen with support and supervision. But inappropriate or incorrect use of antimicrobial drugs, or use of ineffective formulations of drugs, can cause drug resistance.

“Each year, more MDR-TB cases are being reported. In the region, an estimated 68,000 people were afflicted with MDR-TB in 2011,” the report showed.

TB is an infectious bacterial disease that most commonly affects the lungs. It is transmitted from person to person via droplets from the throat and lungs of people with the active respiratory disease.

In healthy individuals, infection often causes no symptoms, since the person’s immune system acts to wall off the bacteria.

The symptoms of active TB of the lungs are coughing, sometimes with sputum or blood, chest pains, weakness, weight loss, fever and night sweats.