C. Vidyashankar,
MD
DELHI (Reuters
Health) - India continues to have the highest incidence of tuberculosis in the
world, according to the global tuberculosis control report 2001, released Wednesday
by the World Health Organization (WHO). The report contains the global tuberculosis
statistics for 1999.
WHO estimates that nearly 1.85 million people, or
185 persons per 100,000, developed tuberculosis in India that year. These new
cases account for nearly one quarter of the total cases worldwide. There were
8.4 million cases of tuberculosis worldwide, up from 8 million in 1997.
"The
tuberculosis epidemic is growing larger and more dangerous every year," WHO officials
caution. Multidrug resistance was present in about 3% of the new cases. Four percent
of the tuberculosis cases were in patients who were also HIV positive.
DOTS
(directly observed treatment short-course) is a treatment strategy in which healthcare
workers directly observe patients taking medication. The technique is used to
ensure that patients take their antibiotics as long as necessary--a process that
can take months. Stopping medication too early is the main reason drug-resistant
strains of tuberculosis develop.
India has reported a treatment success
rate of 84% in the DOTS areas while the areas where DOTS has not been implemented
reported only a 24% success rate. This is an improvement from the last year's
figures of 82% and 18%, respectively.
"India has the second-largest DOTS
program behind China, and is placing more than 25,000 patients on DOTS treatment
every month," according to the WHO report. "Although India has made much progress
in the past 2 to 3 years, two thirds of the population still do not have access
to DOTS as of late 2000." In contrast, 100% of the population in Peru, Cambodia,
Kenya and Uganda have access to DOTS, WHO officials note.
The WHO has chosen
DOTS as its theme for World Tuberculosis Day on March 24th. The WHO calls for
an expansion in the availability of DOTS to all patients with tuberculosis. India
needs to intensify its tuberculosis control strategies, the WHO has recommended.
"The
challenge is to ensure phased, effective expansion (of DOTS) to cover the entire
country," Dr. P. R. Narayanan, director of the Tuberculosis Research Center in
Chennai, India, told Reuters Health. |
