World TB incidence. Cases per 100,000; Red = >300, orange = 200-300; yellow = 100-200; green 50-100 and grey <50. Data from World Health Organization, 2006. (Source: Wikipedia, “Tuberculosis,” http://en.wikipedia.org/wiki/Tuberculosis)
Tuberculosis is the chief cause of death in Swaziland, which has the most TB infections in the world per population. Over a third of the world’s population carries the TB bacterium, but people with compromised immune systems, such as people infected with HIV, are many times more prone to develop active TB. As Swaziland has the highest rate of HIV infection in the world, tuberculosis and HIV go hand in hand: TB is the leading cause of death worldwide among people with HIV/AIDS.
Tuberculosis is a treatable disease. Treatment for active TB involves a long course of several antibiotics (typically 6-12 months) to completely eliminate the TB bacteria from the body. Drug-resistant TB develops often in cases where there is inadequate treatment, compliance, or low-quality drugs. Community-based health programs offer one of the best options for addressing the problem, because in developing relationships with patients, healthcare workers can identify and monitor patients, and educate them about the importance of compliance and completion of treatment.
Particularly problematic are the strains of MDR-TB, multi-drug resistant TB, and XDR-TB, extensively drug-resistant tuberculosis. These are strains of TB that do not respond to the common treatments used in the earliest stages (called “first-line” drugs), or, even to the more expensive next step that is used in case of resistance to the first (called “second-line” drugs). Resistance no doubt occurs in places like rural Swaziland because the people, the healthcare infrastructure, the government, and the economy are plagued by the damage done by the HIV/AIDS epidemic, as well as drought, poor government response, and lack of awareness.
Click on the link below to read a news article about the tuberculosis epidemic in Swaziland.
Swaziland: Tuberculosis still killer number one. (Source: IRIN)