A newly developed TB test, the microscopic-observation drug-susceptibility (MODS) test, surely gives a ray of hope for many. The test is said to be faster, more accurate, cheaper, and more sensitive to drug resistant strains than current tests.
At present, the World Health Organization recommends the sputum smear microscopy test, which analyses the material expelled from the lungs by a deep cough. Although fast, the test is not accurate in around 50% of cases. It can also take up to six weeks to culture the sample, confirm the results and determine whether it is resistant to drugs. And these detailed procedures are seldom available in the developing countries.
With the new MODS test, diagnosis of TB is twice as fast and detection of multi-drug resistance in a third of the time. It was also found out to be more accurate compared to current tests.
Countries with the highest incidence of TB in the Asia-Pacific region include China, India, Vietnam, Cambodia, and the Philippines.
According to the United Nations Economic and Social Commission for Asia and the Pacific (UNESCAP) Report (2006), “Asia as a whole accounts for more than two-thirds of the world’s TB cases and deaths, significantly more than its 60% share in the population.” The reasons for this are the following:
The health systems of many countries do not cater adequately to case detection. As a consequence, the incidence, prevalence, and death rates of many countries are surrounded with uncertainty, which in turn makes control and treatment difficult. It also leads to a lack of monitoring to assure the regularity of drug-taking and the prescription of wrong treatment regimens. Together with an unreliable drug supply, these factors in turn contribute to a high degree of drug resistance.
TB is a contagious disease that spreads through the air, especially in densely populated, unhygienic areas, of which there are many in Asia. TB is common in overcrowded, poorly ventilated slums.
TB is associated with HIV and smoking. TB is a common opportunistic infection in HIV patients; co-infection is particularly common in Thailand, Myanmar, Nepal, Indonesia and India. Smoking increases the risk of TB infection significantly. Tobacco consumption is on the rise in many Asian developing countries, particularly in China. Over half of the TB deaths in Asia are provoked by smoking.
Women also face a higher risk from dying of TB. WHO reports that TB accounts for 9% of deaths among women between the ages of 15 and 44.
The group TB Alert, UK’s National and International Tuberculosis charity, said that TB case detection is much lower in women than men because of the following reasons:
Women delay seeking care so as not to use precious family resources.
Women are missed by health promotion programmes (they tend to stay at home rather than come to workshops) and therefore have a lower awareness of TB symptoms.
Women are often scared to tell family they might have TB due to potential rejection.
Women in some families cannot leave the home without explaining where they are going, but are too afraid to say they want to go to a TB clinic.
Women wait up to twice as long to seek treatment—waiting until they are severely ill and more likely to die.
When asked about the new TB test, Professor Peter Davies, secretary of TB Alert, is optimistic. He said, “This is a very exciting development, which offers the best hope of quick diagnoses for 50% of people in the developing world who are not detected by the current test."
Sources:
“Achieving the MDGs in Asia: a case for more aid?” from the United Nations Economic and Social Commission for Asia and the Pacific, 2006, <http://www.mdgasiapacific.org/events/DFID%20meeting/A_Case_for_more_AIDS_final_version.pdf>.
“Asia-Pacific told to ramp up TB fight” from ABC News Online, posted on September 21, 2006,<http://www.abc.net.au/news/newsitems/200609/s1745778.htm>.
“Faster TB test 'could save lives'” from BBC News, posted on October 11, 2006, <http://news.bbc.co.uk/2/hi/health/6037053.stm>.
“TB and Poverty” from TB Alert <http://www.tbalert.org/worldwide/TBandpoverty.php>.
“TB and Women” from TB Alert <http://www.tbalert.org/worldwide/TBandwomen.php>.
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