We all recognise that scene from films set in the 1800’s and early 20th century: a character, usually a young woman, coughs into a crisp, white handkerchief, the camera pans in to a few drops of blood on the cotton, and we all know she probably won’t make it to the end of the film. Nowadays, the scene would cut to a chest x-ray, a sputum sample being tested, and a course of antibiotics. Despite this decidedly un-cinematic conclusion, preventing the spread of tuberculosis is a global health issue. Tuberculosis remains one of the most stigmatised, most misunderstood, and most deadly infectious diseases in the world.
The World Health Organisation lists 30 high burden countries (HBC) as determined by the impact of TB and the capacity of local health resources to address this impact. Five of the countries in which Palms works are categorised as high burden countries for TB. These include Kenya, Myanmar, Thailand, South Africa, and Papua New Guinea. All of these are of just 14 countries considered high burden for TB, TB and HIV coinfection, and multi-drug resistant TB (MDR-TB).
It is not surprising that many of the countries that feature on these lists are categorised as low-income or have experienced conflict. Both situations exacerbate challenges in providing effective medical treatment for sufferers of, not only TB, but many diseases.
TB is curable and early diagnosis is critical to preventing the spread of TB within high burden countries. Unfortunately, this can be a challenge due to a lack of resources and to stigma associated with TB. In communities which have been affected by untreated or MDR-TB, the correlation between the illness and morbidity leads to stigmatisation of TB patients. The effect of such stigma is that individuals who display TB symptoms delay seeking treatment. That many of these symptoms, such as a recurrent cough, may be disregarded by sufferers as non-infectious respiratory issues makes it easier to delay diagnosis.
Diagnosis itself can be a challenge in remote communities. TB is diagnosed through x-rays and laboratory tests which can be difficult to obtain in areas which lack these facilities or face a shortage of healthcare professionals to conduct screenings and inform patients of the results. In PNG, the gap between detection and treatment is significant.
Preventative treatment for those in contact with TB patients, especially children, has been critical to reducing the spread of the infection. However, coverage of preventative medicine is varied among HBCs, with just 2.1% of children living with those who have confirmed TB being on the treatment, compared to 25% in Kenya.
This World Tuberculosis Day, organisations across the world that work with TB patients aim to build public awareness about the infectious disease and treatment options for those affected. The day is an opportunity to reduce misinformation and stigma in order to reduce the spread of the disease through early diagnosis and effective treatment.