The Tuberculosis Day is observed worldwide on 24th March each year. PENINNAH GATHONI interviews a local medic to explore the clinical aspects of this highly communicable disease. Tuberculosis (TB) is a transmittable disease. It is caused by bacteria known as Mycobacterium tuberculosis. It was first identified in 1882 by a German physician named Robert Koch. The probability of acquiring TB is directly related to the living conditions of the individual. Steve Shaka a local medical practitioner says that as long as we continue to live amongst people we will be exposed to the germ that causes this deadly disease. There are two types of TB –active and inactive. Dr Shaka says that some people live with the TB germ in its inactive form for years without even realizing it. It is only when it becomes active that most patients seek medical attention. “People who are infected can easily pass on the germ that causes this disease and hence anyone is vulnerable to this disease.” The doctor pointed out. There are many ways the disease can be transmitted, for example when singing, coughing and talking. “Some of the symptoms of TB include severe, persistent cough sometimes it can be bloody, chest pain and/or shortness of breath, persistent weakness or fatigue, night sweats this symptoms are however associated with lung TB and may not be present if it is on other body organs. The affected area will normally have a gland swelling indicating the possibility of active TB” Shaka explains. Rwanda’s health ministry revealed during last year’s Tuberculosis day that the prevalence had increased by 20 percent from 2004 to 2008. The report further adds that between 2004 and 2008, the number of TB infected Rwandans rose from 6,367 to 8,014. The World Health Organization’s most recent report on global TB, issued in 2008, showed that an estimated 1.5 million people died globally from TB in 2006. Tuberculosis primarily affects the lungs. However, the infection can spread to other organs. Experts contend that TB mostly affects the lungs; however it is possible to have TB infections in other parts of the body. The kidneys, abdomen, spine, and bones can all be infected by TB. Animals like cows can also get the disease and spread it through their products like milk and meat. Medical statistics indicate that the disease is common among HIV patients who are immune suppressed. Young children and pregnant mothers also have low immunity and are also prone to the disease. The disease he points out is easily transmitted among people in congested areas like prisons. Medics however advise that the disease is treatable, but requires exceptional precision and vigorous treatment spread over a six month period and sometimes even longer. If the condition through which a patient contracts the disease prevails then reoccurrence is a possibility. Shaka observes that after the patient’s screening turns out positive, treatment is conducted in two phases. The first phase takes two months and the last takes four months. Medicines are administered according to the patient’s weight and the periods of administration can vary from patient to another. He continued to explain that that the treatment is highly dependent on the patients discipline since if he or she does not take the drugs as advised it can disrupt the process. Once a patient stops taking the drugs then they have to start the dosage afresh. He explains that if the patient is resistant to the treatment they are moved to a TB sanatorium in Butare for further treatment which can take up to 12 months. All hospitals in Rwanda are implementing the Directly Observed Treatment (DOT) under the Health Ministry and World Health Organization (WHO) as an effort to minimize the disease prevalence. This is a therapy aimed at ensuring that patients take all the medicine in the right combination and for the correct duration in order to assure compliance and to avoid drug resistance. It is hoped that this and other interventions can completely wipe out the disease in the country. pgathoni@gmail.com
