Epidemic Of Tuberculosis In Thailand

[tango]

Basically nobody here cares anyway, How many times have you ever heard of a Thai getting medical tests unless they were in the hospital about to die? Back in the day I would take buses all over Thailand. There always seems to be that one person who cannot stop coughing on the bus and on occasion I was lucky enough for them to sit right behind and cough on me all the way to point B. I no longer take buses and that is the main reason outside the fact they are dangerous in general. I often wonder how many of these folks had TB? Its not like any food worker here is tested for anything or even the food is checked for anything for that matter.

Another big problem in Thailand is leprosy. It is far more common than one would think.

Hmmm...Exactly the reason I gave up taking the bus. There seemed always someone seated behind me coughing on me. Many times I had flu-like symptoms at my destination. Coincidence - unlikely: until the 30B fee came into effect only the rich or near-dead ever saw a hospital; others feared losing their poorly-paid jobs were they to take time off work.

Near CMai there exists an island in the Mae Ping River where the Christian ministry, which also runs McCormick Hospital, houses and cares for many Leprosy patients - for decades now. Probably leprosy, TB and other diseases are endemic in Thailand as a result of the Thai (Buddhist?) belief that the tormented are suffering now for their past indiscretions, so let them suffer. A case of 'Their karma running over their dogma'?

Anecdotal evidence suggests that prisons are rife with TB: one would think that the prison staff would sort this out, if only to protect themselves.

[seonai]

God, I just found this thread!!!!!!! Thanks SRJ for all the info and links. So far my TB is not drug resistant but I only have 25% of my lungs left!!!! I cough up blood a lot....... and I read what you said about the patients in the Phillipines......... AAAAARRRRGGGGHHHHHHH!!!!!!!! Mossfinn has TB too!!!!!! That's two TV members.... any others?

[sriracha john]

I wish you and mossfinn all the best, seonai. The medical treatment has advanced quite a bit since I was in the Philippines. The downside is the emergence of the drug-resistant strains. Follow your doctor's orders carefully and take your medications like clock-work. I'm sorry if my descriptions were disturbing, but there's really no way to sugar-coat it as it is a very destructive disease. With your reduced lung capacity, I'm sure your doctor has told you that you are very susceptible to other problems. Take care of your general health and keep the fight going...

and again, I wish you both all the best.

[seonai]

Thanks SRJ, I like your honesty and it's the only way awareness is going to be raised about TB, I'm currently working with some orgs to do just that! I told Moss about this post so no doubt he'll be commenting soon. Cheers, Seonai

[Mossfinn]

I wish you and mossfinn all the best, seonai. The medical treatment has advanced quite a bit since I was in the Philippines. The downside is the emergence of the drug-resistant strains. Follow your doctor's orders carefully and take your medications like clock-work. I'm sorry if my descriptions were disturbing, but there's really no way to sugar-coat it as it is a very destructive disease. With your reduced lung capacity, I'm sure your doctor has told you that you are very susceptible to other problems. Take care of your general health and keep the fight going...

and again, I wish you both all the best.

Thanks SRJ, I like your honesty and it's the only way awareness is going to be raised about TB, I'm currently working with some orgs to do just that! I told Moss about this post so no doubt he'll be commenting soon. Cheers, Seonai

Thanks for the Good wishes SRJ, I am now in full recovery although it does take a long recuperation process, I fully endorse your statement about following the medication to the letter, because if you stop the meds, then there is a good chance you will be resistant to the usual mix.

I also agree with, ' the non-sugar coated', approach, make people aware and it can be treated successfully, I self diagnosed Flu for a long time before being an emergency case into one of the Hospitals in Oxford.

As others have stated above it can be quite difficult to catch and you do need to have an immunity problem, as I have or be in close contact with an infected person for a lengthy period of time, there are other reasons but they are the most common, as I have been told.

Thanks for bringing this to attention, it really needs to be in the public domain, particularly because of its increase in recent years.

But there is one thing to remember, in the developed world it is not the killer it once was, dangerous and debilitating yes, but not necessarily a killer as it was 50 years ago, it is treatable, the worry that went through my relatives in Ireland when they were told is down to the reminisces of times gone by, although do not ever under estimate it.

I would like to know more about the drug resistant stuff, as I hear this is getting more prevalent, but I know little about this.

Someone also mentioned the contagious period, once taking the meds you are still contagious, from memory for another 2 weeks, but I am not sure about this now, but can check easily enough.

Good Luck

Moss.

P.S Seonai, so good you posted thrice Speak to you soon.

[seonai]

Hi Moss, talk to you soon

[Mossfinn]

Apparently there was a major news story on BBC London yesterday, talking about TB and its increase.

I didn't see it, did anyone else?

What were they saying is behind the increase and any further reason to screen at airports for any visits over 6 months, like Thailand amongst others.

Moss

[geriatrickid]

The article doesn't even scratch the surface of the true extent of the disease in Thailand. An accurate statement cannot be given on the prevalence of infection because Thailand hasn't conducted a comprehensive subnational survey since 1990.

If you want a better indication of whats going on, read the 2007 WHO report. The rate of infection has been increasing for the past 4 years after a period of decrease.

I do not know how reliable the age data quoted by the good doctor is since the Metropolitan Authority did not make available age and sex data for the WHO report. This suggests that either the data is unreliable or just not there. (Note to data p. 256) The doctor also refers to statistics that are interpreted diffferently than those reported under the smear test data and the indicated incidence of 46 /100,000. (P. 255)

If we use the smear test results (cultures) as an indication, then the jump from approx. 8,000. cases in 1998 to approx. 30,000 today suggests a disturbing trend. (new cases identified by smears).

A high incidence of TB goes hand in hand with a high incidence of HIV. It is an opportunistic infection and those with depressed immune systems are susceptible. (Please do not misinterpret this to mean that all HIV+ subjects get TB or that they are the TB reservoir, or that someone who has TB has HIV.) TB has now embarked on it's own life cycle and is cutting a swath through the general population in addition to ravaging the HIV+ population.

Several posters observed that medication must be paid for and therein lies the reason for the spread. In many countries, including the poorest African nations, medication is provided free to encourage treatment. A TB treatment regime is rigorous and requires the patient's cooperation and daily supervision. Thai patients that are not knowledgeable about the disease, i.e. the majority, will deviate from the course of treatment.

When you have patients stopping treatment after a few weeks or months, you create resistant strains of the disease. TB is the poster boy for this condition. Thailand knows what it has to do and must act now. Some courageous public health officials have recommended that a mandatory testing and forced treatment plan be implemented for the regions at risk (Bangkok and the north) but no one is listening. It was also recommended that HIV+ patients be screened but some people assumed this would further ostracize an already marginalized group.

When this disease follows its predicted exponential growth it will have horrendeous ramifications for the economy and the tourist trade. The prime example is what happened to Hong Kong when SARS showed up.

The good news is that there are qualified health professionals on the scene and they are supported by the leading TB prevention & treatment organizations in the world, particularly Canada, the WHO and the USA. Now all we need is the MoH to do what it is told to by its own health scientists.The downside is that by the time a plan is in place alot of people will be infected and die needlessly.

[Mossfinn]

.The downside is that by the time a plan is in place alot of people will be infected and die needlessly.

Well, I hope they get a plan together soon.

The article doesn't even scratch the surface

What article? Are you talking about the article on BBC TV?

If you want a better indication of whats going on, read the 2007 WHO report.

Well, I might, it might help in understanding more about the problem.

30,000 today suggests a disturbing trend. (new cases identified by smears).

Yes it does!

A high incidence of TB goes hand in hand with a high incidence of HIV. It is an opportunistic infection and those with depressed immune systems are susceptible. (Please do not misinterpret this to mean that all HIV+ subjects get TB or that they are the TB reservoir, or that someone who has TB has HIV.)

Once the gate is down and TB being dormant in a lot of unsuspecting people, you are correct it will seize its chance, opportunistic is a very good term for it.

There is no reason to believe that anybody with TB has HIV, the only correlation is as you say, TB attacks a low immune system, not always the case, but a significant danger and HIV will batter the immune system.

Good Post 'kid.

Moss

Edited June 30, 2007 by Mossfinn

[Laulen]

I realise that many if not all of you will not be in the United Kingdom, but, as 'Mossfinn' appears to have spent some time in Oxford, he might be interested in the latest research regarding TB drug developments.

TUBERCULOSIS DRUG DEVELOPMENT

August 26-31, 2007

Magdalen College

Oxford, United Kingdom

More information for you from here

With all good wishes to those of you still recovering from this debilitating disease.

Laulen