Ease soon for Tuberculosis patients

BY INGRID BROWN Senior staff reporter

Monday, March 28, 2011    

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JAMAICA is soon to implement a National Strategic Plan for the treatment of tuberculosis (TB), which will slash hospital admission time and reduce the number of tablets patients have to swallow daily.

National co-ordinator of Jamaica's TB programme Michael Williams told the Observer that the plan, to be implemented later this year, aims to decrease hospitalisation time from two months to two weeks, thus allowing persons to return to their jobs and families once the strain remains negative.

Additionally, instead of taking up to 12 tablets daily, patients will instead take fixed-dose combinations of four pills.

Jamaica's tuberculosis prevalence rate is considered to be relatively low, with only 118 cases recorded last year. A hundred and fifty cases were reported in 2009, of which 53 per cent were found in the south east health region while 24 per cent were in western Jamaica. The cases were found mainly in impoverished communities.

But it's still too many, officials say, and no one should have to experience the emotional and physical pain, as did a 38-year-old man who was diagnosed with the disease a few years ago.

"This sickness is the wickedess sickness me ever face in my life," he said as he addressed a Ministry of Health/ Pan-American Health Organisation (PAHO) workshop on TB at the National Chest Hospital in St Andrew last Thursday.

The man, who cannot be identified by name because of the stigma of the disease, recounted to a rapt audience his experience of being ostracised by his family, being hospitalised for months and having to take as many as 17 tablets and an injection each day.

"Some family members say I can't drink out of their cup and them don't even want me to eat out of the pot that them cook," he said further.

Frustrated with the treatment, he said he initially ran away to live in the bushes as he had nowhere else to go.

"Me used to haffi a wear mask and it used to make me feel a way," he continued.

Coupled with the stigma was his inability to get a job so he could afford food to be able to take the medication.

"Some morning me had to take the medication on hungry stomach," he recalled, adding that there were at least two doctors who went above and beyond the call of duty to encourage him and to offer assistance.

"Finding a job was hard for me because as I get a work and them hear me cough three times them say that cough too terrible and me lose me job," he said, adding that he was also unable to do strenuous manual labour such as lifting heavy objects took a toll on his one functioning lung.

During his months of hospitalisation, the man said he had no visitors except for the nurses and doctors who, according to him, "talk to me and mek me feel like somebody".

Having to spend up to three months at a time in hospital, the man said, is very frustrating to most TB patients.

His tuberculosis now under control, the man has been out of hospital for some months and says he is finally able to make a livelihood selling fruits.

It is issues like those which have seen Jamaica transforming TB treatment through the implementation of a quality Directly Observed Treatment Therapy (DOTS) programme.

While there have been significant achievements since 1930, when TB was the leading cause of death in Jamaica, there are still some challenges in eradicating the disease. Among them is the refusal of some patients to return to treatment centres to verify that they are completely rid of the disease.

Additionally, Jamaica has reported cases of multidrug-resistance TB, the first case being that of a male patient in Kingston and St Andrew who was diagnosed in 2009.

Dr Eva Lewis-Fuller, acting chief medical officer in the health ministry, said the future of TB in Jamaica has to be thoroughly examined, given that HIV/AIDS is one of its driving factors.

As for the strides Jamaica has made in dealing with the disease, Dr Lewis-Fuller pointed to the launch of a TB manual in 2008 for health professionals, the National Strategic Plan, as well as the strengthening of lab capacity to allow for more accurate diagnoses.

She, however, admitted that more needs to be done and that more persons need to get tested.

"Public education advocacy and clinical efforts must be scaled up to meet the international target," she said.




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