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Beware: You can easily catch TB in crowded places, poorly ventilated rooms

An unidentified old woman goes through work in Gangama. Given the type of work she could be at risk of contracting TB.(Photo by DavidMafabi)

KAMPALA – Mr. John Kutosi, 49, left his village for Mbale regional hospital soon after being diagnosed with tuberculosis.

Everyone in the village including his own wife and children shunned him for fear of catching TB.

He now lies at Mbale regional hospital TB ward with nobody to attend to him, he stretches himself, then coughs and spits as other people close to him immediately run away, why? They don’t want to catch TB.

His wife argued that he would expose her children and other people in the village to the infectious airborne disease, and therefore sent him to hospital and asked him to return only after duly completing treatment.

Kutosi now a regular patient at Mbale regional hospital TB ward is reluctant to go home because he has not completed treatment.

When TB infects a patient, she/he suffers from much more than just a health- disease. As if she/he has lost the right to live their lives.

In Uganda especially rural areas, many patients with TB often experience rejection and social isolation.

Kutosi suspects he might have contracted the respiratory disease in his village’s overcrowded and poorly ventilated church where he goes daily for praise, worship and prayer.

Dr Jonathan Wangisi, the Mbale District Health Officer says one can also contract TB from tiny overcrowded prisons with little or no ventilation, and that this is one of the leading factors that make a healthy person vulnerable to contracting TB.

He added that the airborne disease spreads from an infected person when he or she coughs or sneezes, releasing germs into the air.

“The germs may remain suspended in the air for long – especially where there are restrictions in air flow. This explains why proper ventilation is a preventive measure for TB, and overcrowding and poor housing are risk factors for the spread of the disease,” says Dr Wangisi, also the former project director for operational research at The Aids Support Organisation [TASO].

He adds that the excessive use of Tobacco greatly increases the risk of getting TB and dying of it and regular contact with people who are ill increases your chances of exposure to TB bacteria.

Dr Wangisi says that poor nutrition and ill health and people living in unsanitary conditions like refugees and IDPs are at especially high risk of tuberculosis infection.

Causes of TB

Dr Frank Mugabe, the head of the Uganda National Tuberculosis and Leprosy Programme at the Ministry of Health in Uganda says TB is caused by bacteria that spread from person to person through microscopic droplets released into the air and that this can happen when someone with the untreated, active form of tuberculosis coughs, speaks, sneezes, spits, laughs or sings.

“Although tuberculosis is contagious, it is not easy to catch. You’re much more likely to get tuberculosis from someone you live with or work with than from a stranger. Most people with active TB who have had appropriate drug treatment for at least two weeks are no longer contagious,” said Dr Mugabe.

Dr Mugabe says that any injury caused to the lungs especially charcoal, exhaust fumes and smoke can indirectly propagate disease [TB] dissemination.

Dr Wangisi says since the 1980s, the number of cases of tuberculosis has increased dramatically because of the spread of HIV, the virus that causes AIDS.

“Infection with HIV suppresses the immune system, making it difficult for the body to control TB bacteria. As a result, people with HIV are many times more likely to get TB and to progress from latent to active disease than are people who are not HIV positive,” said Dr Wangisi.

He adds that risk of contracting tuberculosis is also higher for people who live in or travel to countries that have high rates of tuberculosis and drug-resistant tuberculosis, including: Africa, Eastern Europe, Asia, Russia, Latin America and the Caribbean Islands

He said other causes include poverty that puts one at lack of medical care needed to diagnose and treat TB and substance abuse for example drug use or alcohol abuse weakens your immune system and makes you more vulnerable to tuberculosis.

INFECTIONS

Anybody is at a risk of contracting TB merely by sharing a poorly-ventilated environment with an infected person who is not yet on treatment.

Tuberculosis remains the one of the world’s most deadly infectious diseases, second only to HIV/AIDS. It can be spread in churches or taxes, whose windows are often shut, especially in the mornings and evenings during rush hour, when most passengers complain about chilly weather if the windows are opened.

“A person without the disease will inhale the germs which then get lodged in the lungs. Most of the time such germs will be kept in check by the body’s immunity and cause no disease. It is a condition known as latent TB or TB infection,” Dr Wangisi says explains.

Dr Wangisi adds that if immunity is lowered, as is the case with HIV, diabetes and malnourished patients, the germs multiply and become full-blown tuberculosis and urges that TB patients should not be quarantined unless they are also suffering from other serious infections or if they refuse to take their medicine.

“This is because TB drugs work quickly to render the patient non-infectious within 72 hours after the patient is put on medication and so Mr Kutosi should have gone back home after accessing treatment,” said Dr Wangisi.

Globally, over two billion people carry the bacterium that causes TB, with approximately 15 million people suffering from an active infection at any given time.

According to a study carried out by the World Health Organization (WHO) and Global Fund, in partnership with the Ministry of Health National Tuberculosis and Leprosy Program and several partners, an estimated 89,000 people get TB disease per year in Uganda, the survey shows but almost half (41,000) of all cases go undetected, exposing more people to infection since they are less inclined to seek treatment.

The study released last year adds that undetected cases are highest in the 15-24 age group and the burden of TB was found to be higher in urban areas (504 per 100,000 persons) than rural in areas (370 per 100,000 persons).

Challenge

The biggest challenge in bringing the number down is that diagnosis is often delayed, and most patients do not adhere to treatment and complete the full dose. This leads to multi-drug resistant TB.

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