Survey indicates Health Ministry winning battle against TB

Officials at the Yemeni Ministry of Health’s National Tuberculosis Control Programme (NTCP) have said they have made great strides in reducing the incidence of tuberculosis (TB).

[Read this report in Arabic]

Amin al-Absi, general director of NTCP, told IRIN Yemen was on track to achieve Millennium Development Goal 6 on reversing the incidence of TB.

Preliminary results of a survey by the NTCP (not available on the internet) in February 2007 showed the prevalence of tuberculin infections was declining by about 5.5 percent a year. It also showed, according to NTCP Statistics Department head Abdul-Bari al-Hammadi, that the annual risk of TB infection had decreased from 0.85 percent to 0.27 percent in 2007.

The survey - conducted among 31,276 school children and financed by the Global Fund to Fight AIDS, Tuberculosis and Malaria, at a cost of US$150,000 - was the first comprehensive national survey and covered 19 of the 21 governorates, according to NTCP. The survey students were given a tuberculin injection, and after three days had their indurations (raised, hardened areas on forearm) measured.

Back-up studies

"The NTCP is working on two studies to confirm the survey results. The first study called Registering TB Cases in the Health System, started on 1 January 2008 and will be completed by the end of March. It will give the real figures of TB incidents in Yemen, as it counts TB cases not only in public hospitals but also private ones," al-Hammadi said, adding that a second study will start in April 2008.

Using Direct Observer Therapy Short course (DOTS), the internationally recommended strategy for TB control, in 2007, the NTCP registered 3,523 cases of new pulmonary TB smear positive; 324 relapse TB cases (people who already recovered from TB and then caught the disease again); 722 new cases of pulmonary TB smear negative; and 770 cases of extra pulmonary TB. But these figures do not include TB cases treated in the private sector.

TB is the world's greatest infectious killer of women of reproductive age and the leading cause of death among people with HIV/AIDS. In Yemen, the disease is the fourth biggest cause of death, according to health workers interviewed in 2007.

According to al-Hammadi, there are 82 cases of TB (all forms) in every 100,000 people in Yemen; and 2,000-2,500 people die annually as a result. He said the reasons for the spread of TB included poverty, malnutrition, and AIDS.

Multi-drug resistant cases

Adnan al-Akahali, head of NTCP laboratories, said multi-drug resistant (MDR) cases were very costly, as they rendered four kinds of TB drugs - RF, INH, SM, and ETB - ineffective. "A survey in 2004-5 examined 790 cases, of which 75 had been undergoing TB treatment, and 715 were new TB cases. The survey found that 2.9 percent of the new TB cases were MDR, and 11.3 percent of the old 75 TB cases had MDR," he said.

According to the World Health Organization (WHO), drug resistance arises due to the improper use of antibiotics in the chemotherapy of drug-susceptible TB patients.

Photo: Mohammed al-Jabri/IRIN

An NTCP poster used to to raise awareness of TB

Othman al-Hasoosah, head of the Activities Department at the NTCP, said his department distributed posters and brochures among TB patients and other people. "We also distribute booklets on TB and ways to prevent it. Awareness makes TB patients continue their treatment and reduces the number of defaulters," he said.

He said the NTCP used radio and TV to raise awareness. "We have intensified awareness programmes on nine local radios," he said.

Visitors to the NTCP can watch videos about TB to better understand the disease. “In 2008, we are targeting 50 schools in three governorates as students can convey awareness messages to their families,” al-Hasoosah said.

maj/ar/cb