diagnostics

Patients wait in a well-ventilated area outside the TB clinic in Homa Bay, Kenya. {Photo credit: A. Kwiecien and A. Salakaia / MSH.}Photo credit: A. Kwiecien and A. Salakaia / MSH.

The state of tuberculosis (TB) is in a tug-of-war as current challenges threaten to undo past successes. One of the primary hurdles currently facing TB prevention and cure is the emergence of strains that are resistant to at least two of the most effective medicines (rifampicin and isoniazid).

So-called drug-resistant (DR)-TB arises when patients are unable to complete a full-course of appropriate, high quality anti-TB medicines. As compared with the 6 month treatment regimen for drug-sensitive (DS)-TB, DR-TB requires 18-24 months of treatment with medicines that are less effective, can cause sometimes severe side effects, and can cost up to 300 times more.

{Photo credit: Katy Doyle / MSH.}Photo credit: Katy Doyle / MSH.

Stop TB in my lifetime.

This global call to action---the Stop TB Partnership's theme for March 24, World TB Day 2013---is as relevant now as it was over a hundred years ago.

Progress toward reducing the global burden of tuberculosis (TB) has been impressive in recent years: TB mortality has fallen by 41 percent since 1990.

Yet, TB remains one of the world’s leading causes of death, killing more than 1.4 million people per year, including 70,000 children. In 2011, 600,000 people died of TB in Africa alone---including many people with HIV.

Low detection rates, new strains of multidrug resistant TB (MDR-TB), high prevalence of HIV/TB co-infection, and risk of TB among diabetes patients---nearly 10 percent of TB cases are linked to diabetes, add to the challenge of TB control, especially among the poor and most vulnerable.

A tray of supplies, including household vinegar, used for screening patients. Masufu Hospital, Uganda. {Photo credit: M. Miller/MSH.}Photo credit: M. Miller/MSH.

Using a basic household item like vinegar to screen for a deadly disease is one of those "Aha!" solutions that will save lives. I had never imagined that I’d get to see the procedure in action.

Cervical cancer kills some 250,000 women every year -- over 80 percent from low-income countries, according to the World Health Organization (WHO). Early diagnosis can save lives, but many health facilities in developing countries struggle to find a way to screen women in remote, overcrowded settings. Last year, The New York Times talked about the success of using vinegar as a cervical cancer diagnostic method in Thailand, and yesterday SHOTS, NPR's health blog documented its life-saving use in Botswana.

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