For Some, Tuberculosis Diagnosis is a Prison Sentence Without End

xdr-tbAccording to the BBC, in some parts of the world being diagnosed with Extreme Drug Resistant Tuberculosis(XDR-TB) is equivalent to being handed an indefinite prison sentence.

Tuberculosis is a public health crisis and has been declared a national emergency in South Africa.   Estimates suggest that nine million people contract standard TB every year.  Ninety percent of those who contract TB living in the developing world. 

The standard course of TB treatment is six months of antibiotics.  For most people, this treatment works so long as they continue to take the drugs for the entire six months.  Health care workers attempt to ensure that people stick with their treatment by requiring that patients go to a clinic every day and be watched taking their pills. Some patients feel better after a couple of months, however, and stop coming.

This failure to finish treatment enables the bacteria to build resistance to the drugs.  It is this “non-compliance” that has led the bacteria to mutate into two drug-resistant strains of MDR-TB and the much more dangerous strain XDR-TB. They are now found in 45 countries.

According to the WHO, and based on data from an XDR-TB outbreak in South Africa, XDR-TB has an alarmingly high mortality rate.  Of the 544 patients studied, 221 had MDR-TB. Of the 221 MDR-TB cases, 53 were defined as XDR-TB. Of the 53 patients, 44 had been tested for HIV and all were HIV-positive.  52 of 53 patients died, on average, within 25 days.

Protecting the public’s health has become the focus in the battle against these new drug-resistant strains of TB.  It is why people with the new strains are being kept virtual prisoners, even if the cost is their personal freedom.  Patients are generally required to stay in the hospital until they have tested negative for TB.   As of now, only one XDR patient in the South African hospital has left permanently cured.

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