Despite achieving a remarkable success in detection and treatment of TB, it is still a major public health problem in Bangladesh as nearly 5,000 patients are diagnosed with MDR-TB every year. In Bangladesh, the estimated incidence rate for all forms of Tuberculosis in 2015 was 225 per 100,000 population while the incidence rate for MDR-TB was six per 100,000 population.
Community-based treatment programmes such as DOTS-Plus, and MDR-TB-specialised treatment using the popular Directly Observed Therapy — Short Course (DOTS) initiative have shown considerable success in the treatment of MDR-TB in some parts of the world, including Bangladesh.
These programmes are proven to be a good option for proper treatment of MDR-TB in the poor and in rural areas. The Bangladeshi government has introduced DOTS in 1993 and the programme has achieved remarkable progress in TB Control. The programmes have successfully treated 94 percent of bacteriologically confirmed new pulmonary TB cases registered in 2014.
Almost 2.5 billion people, or one third of the World’s population, are thought to be infected with tuberculosis. Most infected people have latent TB, meaning they have the tuberculosis germs in their bodies, but their immune systems protect them from becoming sick. However, over 9.6 million people have active TB disease, worldwide, so the fact that 80 percent of our population has the latent version of the disease is not something to worry over — the incidence of TB worldwide is less than 0.4 percent — meaning less than 1/250 people who have the germs will actually have the chance of getting the infection in their lives in any year.
Tuberculosis is closely linked to both overcrowding and malnutrition, making it one of the principal diseases of poverty. Those at high risk thus include: people who inject illicit drugs, inhabitants and employees of locales where vulnerable people gather (e.g. prisons and homeless shelters), medically underprivileged and resource-poor communities, high-risk ethnic minorities, children in close contact with high-risk category patients, and health-care providers serving these patients.
Chronic lung disease is another significant risk factor. Silicosis increases the risk about 30-fold. Those who smoke cigarettes have nearly twice the risk of TB compared to non-smokers. All of these causal factors can be fought to ensure that the spread of TB remains limited and not widespread. Essentially alleviating economic factors such as poverty, increasing public sanitation and vaccination alongwith information related mass media programmes are essential for fighting this disease.
