Kathmanduites more vulnerable to tuberculosis

April 04, 2018

The Himalayan Times, 03 April 2018

A report published by National Tuberculosis Centre has shown that people living in Kathmandu are more vulnerable to tuberculosis.

As per the report, of all the TB cases recorded, 41.2 per cent of cases were reported from the central region, of which 35 per cent was from Kathmandu Valley and 25 per cent was from Kathmandu district.

Dr Kedar Narsingh KC, director at National Tuberculosis Centre, informed that a total of 31,764 TB cases were reported in the fiscal 2016-17. “The city is crowded and pollution is high in this region. Excess migration to the city and malnutrition are some of the causes behind people suffering from tuberculosis,” he added.

According to National Tuberculosis Centre, most cases are from middle age groups with the highest of 47 per cent in the 15 to 44 age group. TB in children is around 5.6 per cent and males are nearly 1.8 times more than females in the 2016-17.

People living in urban set-up with dense population are prone to infection. As tuberculosis is transmitted through air, people living in crowded and polluted areas are more vulnerable to the disease. Moreover, health practitioners are also suffering from multi-drug resistant tuberculosis. Roughly, there are about 1,000 MDR-TB cases in the country.

From among 1,000 patients, only 343 enrolled themselves for treatment through DOTS centres under National Tuberculosis Programme in 2016-17, Dr KC informed. As many as 4,321 centres provided treatment for the disease.

“As we lack isolated centres for treating MDR-TB patients, health practitioners are also suffering from the disease. Nurses, paramedics, lab technicians among others are suffering from multi-drug resistant tuberculosis,” said TB specialist Dr Mohan Kumar Prasai.

“It is necessary to keep patients suffering from multi-drug resistant TB in isolated centres to prevent the spread of MDR-TB. The isolated centres should ideally be located at least seven to eight kilometres away from public areas,” added Dr Prasai.

Multi-drug resistant tuberculosis is a form of tuberculosis infection caused by bacteria that are resistant to treatment with at least two of the most powerful first-line anti-TB medications. “The tendency of TB patients dropping out of treatment is increasing as the treatment course spans over 24 months. Irregular medication among TB patients leads to resistance to first-line anti-TB medications. These patients are ultimately diagnosed with MDR-TB,” said Dr KC.

“The government should set up isolation centres in places where population density is low. MDR-TB patients are to be treated in such isolation facilities to prevent the disease from spreading to health practitioners and the public,” said Dr Prasai. He added that such facility needed to be built in each province.

To attain Sustainable Development Goals, Nepal has to eradicate TB by 2030, however, increasing cases of multi-drug resistant TB have turned out to be a major hurdle in achieving SDGS.