Sunday, September 03, 2006

Tuberculosis in Haiti

Tuberculosis in Haiti

The proud father with his beautiful little girl live in Cite Soleil in Port-au-Prince. The father reports that his daughter has had a fever for months and is not gaining weight. Her physical exam was normal but her chest x ray reveals pneumonia in both lungs that may represent pulmonary tuberculosis. She is being “worked up” for this now. Her father sneaks her out of Soleil to her appointments.

Some one said that tuberculosis is a “social disease with medical consequences”. This just means that poor populations of people get it and suffer the terrible effects of the disease. In the United States, the prevalence of tuberculosis decreased before effective drugs were introduced. This was due to the improved standard of living that North Americans were experiencing as they moved out of the ghettos and obtained good jobs. Their immune systems improved and less people had tuberculosis so less could spread it.

Tuberculosis is the most common infectious disease worldwide and endemic in the developing world. It is spread much easier than is HIV, malaria, or hepatitis. The tuberculosis germs are airborne. Lungs are the primary site for the deposition of tuberculosis but the germ can go anywhere and infect every organ system.

Mortality is 50-80% in untreated smear positive cases, but is less than 5% with active tuberculosis programs. Overall “success” in treatment of tuberculosis in Haiti is 70%.

In 2005, in the United States, there was the lowest incidence of tuberculosis ever recorded—4.8/100,000 people. The incidence in Haiti for 2002 was 319/100,000 people. This disparity is incredible. Remember, the United States has about 290 million people and Haiti has 8.6 million. Regarding tuberculosis, Haiti is ranked at 151/194 countries for prevalence of tuberculosis. Not real good.

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