The Telegraph
Since 1st March, 1999
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WHO rings TB alarm

New Delhi, Aug. 10: More than 50 per cent of HIV patients the world over will die of tuberculosis, unless given proper treatment.

Two-thirds of all HIV-positive people seeking treatment for TB are either misdiagnosed or not treated properly, says the World Health Organisation. The risk of HIV patients dying of TB is greater in India, where an estimated 60 per cent of the 36.8 million HIV patients are afflicted by TB.

“About a third of the HIV population all over the world is infected with mycobacterium TB, which is one of the earlier infections to appear in a HIV patient,” say experts in the Union health ministry. TB kills one out of every three persons with AIDS.

“Failure to use the directly observed treatment, shortcourse, can lead to a massive explosion in TB with cases tripling and resistance to drugs rapidly increasing,” says Dr Deepak Gupta in charge of the health ministry’s national TB control programme.

Unchecked tuberculosis among HIV patients will lead to a proliferation of TB cases as HIV increases the risk of re-activation of the infection in people with latent TB infection, says Gupta.

“These people can spread TB to other people. HIV is the most powerful risk factor for progression from TB infection to TB disease,” says the ministry. TB, in turn, accelerates the progression of HIV to AIDS and shortens the survival period of HIV patients.

The directly observed treatment has been largely successful in treating TB in India — a country where 2 million people contract TB every year and 450,000 die from it. The infection kills 14 times more people than all tropical diseases combined, 21 times more than malaria and 400 times more than leprosy.

The shortcourse treatment now covers 60 per cent of those in India infected with TB. The upgraded treatment launched in 2002 has worked because it tackled the infection at its roots.

The programme ensures that patients take anti-TB medicine every day without fail. Health workers administer the medicines on a day-to-day basis so that the patient does not forget to take the medicine once he or she is better but has not run through the whole course.

This, according to the WHO, is the most common factor leading to the death of patients. Unsupervised TB treatment also increases the likelihood of the patient not recovering.

“This improper TB treatment also allows patients to remain infected for longer, thereby putting family members, friends and health workers at considerable risk of becoming infected with TB,” says the WHO.

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