MoPH Celebrates World TB Day

Press Release - Afghanistan Ministry of Public Health

Kabul 11 March 2009: Tuberculosis (abbreviated as TB for tubercle bacillus or Tuberculosis) is a common and deadly infectious disease caused by mycobacteria, mainly Mycobacterium tuberculosis. Tuberculosis most commonly attacks the lungs (as pulmonary TB) but can also affect the central nervous system, the lymphatic system, the circulatory system, the genitourinary system, bones, joints and even the skin. Over one-third of the world's population has been exposed to the TB bacterium, and new infections occur at a rate of one per second. Not everyone infected develops the full-blown disease; asymptomatic, latent TB infection is most common. However, one in ten latent infections will progress to active TB disease, which, if left untreated, kills more than half of its victims.

Each year World TB Day is celebrated with a slogan in the last week of March. Slogan for the year 2008 and 2009, which has been adopted by the World Health Organization (WHO), is “I am stopping TB, Million Youth March”.

Afghanistan Millennium Development Goal (MDG) 6, Target 8 is focusing to halt and begin to reverse the incidence of TB by 2020. The Afghanistan targets, endorsed by the Global Stop TB partnership, are as follows:

1. To detect at least 70% SS+ cases and to increase cure rate to 85% by 2010.
2. To reduce TB Prevalence and death rates by 50% by 2015.

The National TB Control Programme of the Ministry of Public Health has adopted the strategy of Direct Observed Treatment Short course (DOTS) for the management and treatment of TB patients. DOTS centers have increased from 30 in 2001 to 1031 in 2008 all over the country. The Case Notification Trend has also increased from 9581 cases in 2001 to 28769 cases in 2007.

Some facts about the status of TB in Afghanistan:

1. Incidence (all new TB cases) is 161/100,000 population/year
2. Incidence with Sputum Smear Positive (SS+) cases is 73/100,000 population/year
3. Prevalence (old and new cases) is 231/100,000 population/year
4. Case detection of new SS+ 68 %
5. Treatment success 89%
6. Proportion of female 67%
7. New cases each year 39445
8. Number of deaths each year 7840

67% of all TB patients in Afghanistan are women. Why women are so vulnerable to TB in Afghanistan? Following are the factors that could be blamed for high TB morbidity among women in Afghanistan:

• Economic Situation

1. Completion of treatment course
2. High transportation cost
3. Cost of overnight facilities

• Environmental situation

1. Spent in overcrowded dwellings
2. Inhaling the unhealthy air (Dust, smoke, etc).
3. Contamination through clothes

• Alimentary situation

1. Low food intake by women
2. Low protein content of the food
3. No access to extra-food

• Individual psycho-physical situation

1. Decrease in immune response
2. Deaths & Family trouble

• Stress

• Psychological
• Family
• Physical (Frequent Pregnancies, hard home work,..)
• Social & economical

• Health situation
• Diagnosis is often late
• Relation Doctor/Patient is usually very difficult
• Medical/Technical training is inadequate
• Financial support is inadequate

Fortunately MoPH partners have been very generous in this regard. Main donors for the National TB Control Programme are WHO, Italian corporation, USAID, CIDA, JICA, GDF, and Global Fund. MoPH Afghanistan is indebted to many individuals and health stakeholders, especially Afghan families and elders, European Commission, UNICEF, Rotary International and Global Alliance for Vaccines and Immunization (GAVI Alliance).

Ministry of Public Health delivers health services impartially and without any form of discrimination to the needy people of Afghanistan in all corners of the country and requests all parties to respect this policy and support health care providers to fulfill this noble job.