From her bed in the Aung San TB Hospital on the outskirts of Yangon, the former Burmese capital, 17-year-old Aye Aye Aung waited to hear if her tuberculosis (TB) had worsened.
Though her symptoms first emerged in late 2007, neither she nor her family knew enough about the infectious respiratory disease to seek help.
Instead, she took a barrage of over-the-counter drugs to control her coughing, and only learned she was infected after finally visiting her local clinic in Sittwe, capital of Myanmar’s northwestern Rakhine State.
By that time, it was too late. The clinic was unable to help her, and she was referred to the Aung San TB Hospital, one of only two TB hospitals in the country.
"We should have been better informed about how important early treatment was. That would have helped her,” said one of Aye Aye Aung’s sisters.
Lack of awareness
Like most Burmese, Aye Aye Aung had little or no knowledge about TB and how to treat it, even though the disease is one of Myanmar’s major public health problems.
TB sufferers are also often unaware that free, public treatment is available through the National TB Programme (NTP), and end up spending money they can ill afford at private clinics.
"Community awareness is crucial in fighting TB,” an official from NTP told IRIN. "Not knowing to get early treatment and to take the drugs on a regular basis can worsen the patient’s prognosis, as well as increase the risk of infecting others.”
While government and international health agencies are undertaking education campaigns, public awareness is still low, say health workers.
Agencies lack the funds for widespread information campaigns, while few people have access to the mass media or own televisions in the impoverished nation, which also suffers from a severe electricity shortage.
“A lack of awareness of the disease among the public helps the high prevalence [of TB],” said Ye Myint, a TB consultant with the UN World Health Organization (WHO), adding that public awareness needed to be promoted nationwide.
Controlling TB a challenge
In Myanmar, TB ranks as a priority disease in the national health plan, along with malaria and HIV/AIDS.
The country is among 22 nations in the world with the highest TB burden, and among 27 countries worldwide with the highest burden of multi-drug resistant TB (MDR-TB), which is immune to treatment by standard frontline drugs.
According to the WHO’s Health in Myanmar 2009 Report, estimates suggest that 1.5 percent of the population of about 57.5 million become infected with the TB bacilli every year.
Of these infections, about 130,000 people develop tuberculosis, and half of these are smear-positive cases, which means they are the most infectious.
The WHO’s recommended strategy for the detection and cure of TB is directly observed treatment short course (DOTS), whereby the patient is monitored to ensure they take their medication regularly and in the right combination.
While Myanmar achieved near-nationwide DOTS coverage by the end of 2003, problems remain, according to medical NGO Médecins Sans Frontières.
"Often there is a lack of financial resources and a shortage of staff in public health facilities, and providing information to patients is often overlooked," MSF medical supervisor, Myo Set Aung, told IRIN.
Other health workers report that some patients fail to take their drugs on schedule or to complete treatment, often stopping when they feel better. As a result, some TB patients are not able to fight the disease successfully or they spread it to their communities, while others develop MDR-TB, which is more expensive and difficult to treat.
In addition, access to treatment is a challenge, especially in rural areas, where 70 percent of the population live. Travel to health clinics can be difficult and expensive and sometimes takes days.
"If health structures are far away, people may turn to self-medication instead. You can find all sorts of TB drugs and purchase them without prescription, which poses a risk of treatment failure," said Myo Set Aung.
contributor/ey/mw
Though her symptoms first emerged in late 2007, neither she nor her family knew enough about the infectious respiratory disease to seek help.
Instead, she took a barrage of over-the-counter drugs to control her coughing, and only learned she was infected after finally visiting her local clinic in Sittwe, capital of Myanmar’s northwestern Rakhine State.
By that time, it was too late. The clinic was unable to help her, and she was referred to the Aung San TB Hospital, one of only two TB hospitals in the country.
"We should have been better informed about how important early treatment was. That would have helped her,” said one of Aye Aye Aung’s sisters.
Lack of awareness
Like most Burmese, Aye Aye Aung had little or no knowledge about TB and how to treat it, even though the disease is one of Myanmar’s major public health problems.
TB sufferers are also often unaware that free, public treatment is available through the National TB Programme (NTP), and end up spending money they can ill afford at private clinics.
"Community awareness is crucial in fighting TB,” an official from NTP told IRIN. "Not knowing to get early treatment and to take the drugs on a regular basis can worsen the patient’s prognosis, as well as increase the risk of infecting others.”
While government and international health agencies are undertaking education campaigns, public awareness is still low, say health workers.
Agencies lack the funds for widespread information campaigns, while few people have access to the mass media or own televisions in the impoverished nation, which also suffers from a severe electricity shortage.
“A lack of awareness of the disease among the public helps the high prevalence [of TB],” said Ye Myint, a TB consultant with the UN World Health Organization (WHO), adding that public awareness needed to be promoted nationwide.
Photo: Gary Hampton/World Lung Foundation  |
| Lack of awareness means patients often do not finish the treatment, resulting in resistant TB and further illness |
In Myanmar, TB ranks as a priority disease in the national health plan, along with malaria and HIV/AIDS.
The country is among 22 nations in the world with the highest TB burden, and among 27 countries worldwide with the highest burden of multi-drug resistant TB (MDR-TB), which is immune to treatment by standard frontline drugs.
According to the WHO’s Health in Myanmar 2009 Report, estimates suggest that 1.5 percent of the population of about 57.5 million become infected with the TB bacilli every year.
Of these infections, about 130,000 people develop tuberculosis, and half of these are smear-positive cases, which means they are the most infectious.
The WHO’s recommended strategy for the detection and cure of TB is directly observed treatment short course (DOTS), whereby the patient is monitored to ensure they take their medication regularly and in the right combination.
While Myanmar achieved near-nationwide DOTS coverage by the end of 2003, problems remain, according to medical NGO Médecins Sans Frontières.
"Often there is a lack of financial resources and a shortage of staff in public health facilities, and providing information to patients is often overlooked," MSF medical supervisor, Myo Set Aung, told IRIN.
Other health workers report that some patients fail to take their drugs on schedule or to complete treatment, often stopping when they feel better. As a result, some TB patients are not able to fight the disease successfully or they spread it to their communities, while others develop MDR-TB, which is more expensive and difficult to treat.
In addition, access to treatment is a challenge, especially in rural areas, where 70 percent of the population live. Travel to health clinics can be difficult and expensive and sometimes takes days.
"If health structures are far away, people may turn to self-medication instead. You can find all sorts of TB drugs and purchase them without prescription, which poses a risk of treatment failure," said Myo Set Aung.
contributor/ey/mw
This article was produced by IRIN News while it was part of the United Nations Office for the Coordination of Humanitarian Affairs. Please send queries on copyright or liability to the UN. For more information: https://shop.un.org/rights-permissions
Share this article
