RIYADH, 25 March 2004 — Yesterday was World Tuberculosis Day. It was an excellent opportunity to raise awareness of the disease. Affecting one-third of the world’s population, tuberculosis kills two million people every year. The World Health Organization (WHO) declared it a “global emergency” in 1993 and is endemic to Saudi Arabia where it affects 30 out of every 100,000 people.
Dr. Muhammad Saleh Al-Hajjaj, president of the Saudi Thoracic Society, said tuberculosis is not uncommon in Saudi Arabia and that there is “medium prevalence” of the disease in the Kingdom.
In 2001, there were an estimated 4,206 cases of tuberculosis infections in the Kingdom compared to 4,069 in 2000 and 4,180 in 1999. Dr. Al-Hajjaj called for increased awareness and education about tuberculosis, the symptoms of which are often overlooked by both patients and general practitioners.
Tuberculosis is a communicable disease caused by slow-growing bacteria that thrive in the lungs and other areas rich in blood and oxygen. Symptoms include a persistent cough with fever, fatigue and weight loss. A persistent cough lasting for more than two weeks with no obvious causes may be a sign of developing tuberculosis.
According to experts, people displaying symptoms should contact a doctor or health professional for a tuberculosis skin test. Medical attention should be immediately sought after close or lengthy contact with a person who has an untreated active tuberculosis infection.
A person with latent tuberculosis carries the bacteria but does not exhibit symptoms or spread the disease unless the bacteria become active. Certain conditions can increase the risk of developing active tuberculosis such as HIV infection, a weakened immune system, poor access to health care as well as alcohol and drug abuse.
Pulmonary tuberculosis is the most contagious form and is easily spread by inhaling bacteria-containing air. Of those with latent tuberculosis, five percent will develop active TB within two years of the initial infection. Another five percent of those with latent TB develop active TB at some point in their life.
Another problem Dr. Al-Hajjaj mentioned was misdiagnosis by general practitioners and health care workers. If untreated, tuberculosis can be fatal or cause serious complications such as blocked airways, bleeding and lung abscesses. Discontinuing treatment may also have negative consequences including a relapse of the disease and the development of antibiotic resistant bacteria. Relapses usually occur six to 12 months after treatment.
There are a number of steps that people can take to avoid active tuberculosis infection. They should not spend extended periods in small, enclosed areas with someone suffering from active tuberculosis. Health care workers should use protective clothing and equipment when handling infected patients. In addition, children should be immunized against tuberculosis and infants who are especially vulnerable to disease should not be taken to crowded areas where the risk of infection is higher.
The history of tuberculosis outbreaks indicate that crowded places such as hospitals, schools and prisons are likely areas of infection. Dr. Al-Hajjaj said although there had not been a significant rise in tuberculosis among the general Saudi population, there have been “blips of increased infection during pilgrimage and Haj season.”
Dr. Al-Hajjaj said in spite of the increased literature and media coverage of the dangers of tuberculosis, a large-scale campaign to prevent the disease has yet to be launched. He stressed the urgent need for new research on tuberculosis in the local population. “I call on the Ministry of Health to make a greater contribution to tuberculosis research,” he said.
