The Irish Thoracic Society (ITS) urges against complacency in the fight against Tuberculosis (TB) – a contagious but controllable disease that continues to pose significant public health challenges as Ireland sees a rise in cases of difficult to treat multi-drug resistant (MDR) TB.
To mark World TB Day, Monday 24th March, the ITS has identified a number of principles that are central to tackling TB:
Educate healthcare professionals and members of the public to recognise the symptoms of TB. Routine testing for TB should be encouraged in patients with persistent cough and phlegm or other symptoms of TB such as weight loss and night sweats. Patients experiencing these symptoms are encouraged to see a health care professional. Microbiology laboratories should be funded to test for TB on a routine basis and to enhance TB diagnostic facilities.
Improve outcomes and reduce spread of TB by ensuring patients follow and complete treatment for TB using Directly Observed Therapy (DOT). High rates of treatment failure are a serious issue in the management of TB and can be avoided through DOT, where patients are assigned a healthcare professional to monitor their treatment and ensure compliance with medication. Ireland falls short of World Health Organisation recommendations with regard to the routine practise of DOT.
Control the spread of multi-drug resistant TB (MDR-TB). This is a form of TB that fails to respond to standard first-line drugs and is therefore difficult and expensive to treat. MDR TB has been described by the WHO as a global health security risk. With the rate of MDR TB in Ireland rising (4 cases out of 384 were reported in 2013) Ireland is facing this risk along with the rest of the world.
TB is a controllable disease – prevention is key. TB infection can be detected by screening for latent TB. This is where infection exists but is not contagious and there are no symptoms of illness. If the disease is treated in its latent form it will prevent the development of an active, contagious form of the disease. The Irish Thoracic Society supports the establishment of a national programme to screen for and treat latent TB in high risk groups to reduce the incidence of the disease in Ireland.
“TB has not gone away. Its contagious nature means that communities are vulnerable if the proper safeguards are not in place. Early detection is critical and this means recognising symptoms of TB and screening for latent infection in at risk populations. Like other countries the rate of resistant TB is rising which reinforces the need for improved treatment programmes including Directly Observed Therapy (DOT) .” Said Dr Antony O’Regan, President of the Irish Thoracic Society.
Facts about TB
1. Tuberculosis (TB) is contagious and spreads through the air. A person with infectious TB can expel TB germs into the air when they cough, sneeze, laugh, or even sing. People in the surrounding area can then inhale these TB germs. If not treated, each person with active TB can infect on average 10 to 15 people a year.
2. In 2013, 384 cases of TB (8.4 per 100,000 population) were notified to the Health Protection Surveillance Centre (HSPC). 1
3. TB rates in Ireland have been declining for more than half a century, from almost 7000 cases in the early 1950s to approximately 400 at the turn of the millennium.
4. Worldwide an estimated 8.6 million people developed TB in 2012 and 1.3 million died from the disease (including 320 000 deaths among HIV-positive people – which accounts for one fifth of all deaths from HIV). 2
5. Tuberculosis (TB) is second only to HIV/AIDS as the greatest killer worldwide due to a single infectious agent. 2
6. Over 95% of TB deaths occur in low- and middle-income countries, and it is among the top three causes of death for women aged 15 to 44. 2
7. Worldwide an estimated 530 000 children became ill with TB and 74 000 HIV-negative children died of TB in 2012. 2
1. National TB Surveillance – Quarter 1-4 2013 TB Report – http://www.hpsc.ie
2. World Health Organisation (WHO) http://www.who.int/mediacentre/factsheets/fs104/en/