Tuberculosis in Asia

[waltky]

Lil' Kim squanders money on missiles while his malnourished people die of TB...

WHO: 5,000 North Koreans die annually from tuberculosis
Oct. 29, 2015 - Total deaths due to tuberculosis in North Korea have declined by 1,700 since 2013, but the disease still persists with 110,000 current TB patients.

North Korea's tuberculosis deaths are declining, but 5,000 North Koreans still die from the disease annually. The data from the World Health Organization was included in a report that indicated TB has surpassed the human immunodeficiency virus, or HIV, as the leading cause of global death. Voice of America reported 20 out of 100,000 North Koreans die of TB, or at a rate that is 5-10 times that of neighboring countries: In South Korea, 3.8 out of 100,000 succumb to TB, the death rate is 2.8 per 100,000 in China, and the rate in the region is lowest in Japan, where it stands at 1.8 per 100,000.

An estimated 20 out of 100,000 North Koreans die of tuberculosis, or at a rate that is 5-10 times that of neighboring countries, The problem lies with the rise of multiple drug-resistant tuberculosis, or MDR-TB, among patients in the country.​

Total deaths due to tuberculosis in North Korea have declined by 1,700 since 2013, but the disease still persists, and the country now has 110,000 TB patients – or 442 per 100,000, the second-highest in Asia after East Timor. The problem lies with the rise of multiple drug-resistant tuberculosis, or MDR-TB, among patients in the isolated country. They now number 3,800, according to the WHO. A source at the U.N. body told VOA that it plans to investigate the emergence of MDR-TB patients in North Korea. But Philippe Glaziou, senior epidemiologist for the WHO, said TB rates in North Korea are generally declining, and the recovery rate of TB patients in 2013 was 92 percent.

A U.N. inspection of North Hwanghae province showed that 15 percent of past patients suffered from recurring tuberculosis, and new TB patients comprised nearly 2 percent of the province's total TB population. In May, the U.N. said women in North Korea who look after the patients are highly vulnerable, and children who come into contact with the patients or caretakers are also in need of immunization. An estimated 1.5 million people died globally from tuberculosis in 2014.

WHO: 5,000 North Koreans die annually from tuberculosis

 

[Unkotare]

The people in North Korea are dying from North Korea. Cure that disease and they'll recover quickly enough.

 

[waltky]

TB free by 2030...

WHO: Tuberculosis Can Be Ended by 2030
March 22, 2016 — In advance of World TB day (March 24), the World Health Organization is calling for collective global action and more money to support TB control strategies to end this scourge by 2030.

The World Health Organization says ending tuberculosis by 2030, the target set by the U.N. Sustainable Development Goals will be a challenge, but it can be done. It notes 43 million peoples’ lives have been saved since 2000. WHO says countries can save the lives of the 1.5 million people who continue to die from tuberculosis every year by strengthening TB programs and adopting newer tools. Director of WHO’s Global TB Program, Mario Raviglione, says several of the 30 countries with the highest TB burden are implementing newer TB strategies with some success. One such country is India, home to more people ill with TB and multidrug-resistant TB than any other country in the world. He says the country is making progress in providing universal access to TB care for patients.

South Africa is another country that has expanded access to a rapid molecular test for TB and drug-resistant TB. “South Africa is, let us remember, home to the largest number of people living with HIV who are receiving also TB preventive treatment. So, worldwide there are these sort of pathfinders for prophylaxis of tuberculosis, which is one of the other new elements of the new strategy that we are very much insisting on because it prevents tuberculosis and saves lives," said Raviglione. WHO cites Thailand, Russia, Brazil, and Vietnam for running successful TB control programs. The multinational health group UNITAID is working with the WHO by investing in effective approaches to end TB. For example, it is scaling up better TB treatment for children.

Every year, an estimated one million children become ill with TB and some 140,000 die. UNITAID team leader Janet Ginnard says medicines suitable for children in the right doses and formulations now are available. She tells VOA before WHO revised its treatment guidelines, children were thought of as just little adults. She says no one recognized the need to tailor the dosage for children. “So, the drugs that we had were either child-friendly dissolvable, but not in the right doses or crushed and split pills from adult medicines to try to make up those doses - so, both sub-optimal work-around solutions," said Ginnard. Ginnard says these new child friendly medicines now can be bought on the market in doses that are right for treating tuberculosis in children.

WHO: Tuberculosis Can Be Ended by 2030

 

[waltky]

DR-TB adds to India's tuberculosis menace...

Drug resistance adds to India's tuberculosis menace
23 Mar.`16 - After three years of battling tuberculosis, a disease that claimed the lives of his father and younger brother, Sonu Verma, a patient in northern India, hopes a cure for his illness may be within reach.

"Only a few more months and my nightmare will end... it will be my rebirth, free from tuberculosis," the 25-year-old scrap dealer, who has been left visibly lean and weak by the disease, told AFP. As India marks World TB Day on Thursday, it faces an estimated 2.2 million new cases of the disease a year, more than any other country, according to the World Health Organisation. The government says it is stepping up its fight, with Health Minister J.P. Nadda earlier this week launching a new drug to help beat the growing menace of drug-resistant tuberculosis. Treating TB successfully requires patients to follow a strict, months-long drugs regimen -- or risk their disease becoming drug-resistant.

Tuberculosis patient Sonu Verma (R), 25, seen with his wife and child at their home in Sonipat, India​

But factors such as inadequate medical facilities, lack of knowledge, poverty and social stigma mean drug resistance is a growing problem. Verma, who lives in the district of Sonipat in Haryana state, was told he had TB in 2013. A year later he was found to have multi-drug-resistant TB, after failing to complete his initial course of treatment because of a shortage of money and poor medical advice. "It was the worst time of my life," Verma told AFP. "I was always tired, I couldn't eat, couldn't work and couldn't even be close to my family."

Tuberculosis patient Sonu Verma, 25, poses with his chest x-ray, in Sonipat, India​

Verma was tracked and counselled by volunteers from Axshya, a civil society project backed by the Indian government that works to ensure that TB patients complete their treatment. Now he is taking a new drug and doctors say his prospects are good. Despite the efforts of the national TB programme, hundreds of thousands of cases go undiagnosed each year, Dr Sarabjit Chadha, project director of Axshya, told AFP. "There are a significant number of cases who are still not coming for diagnosis and treatment," he added.

Tuberculosis patient Anita (R), 23, seen at her home in Sonipat, India​

Kushminder Balhara, a local medical practitioner who has been practising in Sonipat for almost 15 years, said attitudes towards the disease were slowly changing. "Earlier, people used to be reluctant to say that they wanted to get tested for TB because of the social stigma," Balhara told AFP. "Now, knowing some of the TB symptoms, I refer at least two to three suspected TB cases to government facilities every month."

Drug resistance adds to India's tuberculosis menace

 

[waltky]

New TB initiative spots latent carriers...

New Initiative Spotlights TB Prevention in Latent Carriers
May 23, 2016 — UNITAID, a global health initiative, is taking the old adage “prevention is better than cure” to heart. To that end, it has just launched a new multi-million dollar initiative to finance new treatments that can prevent the onset of full-blown tuberculosis in hundreds of millions of people globally living with latent TB.

Executive Director Lelio Marmora told VOA his organization is prepared to spend between $40 and $80 million on innovative proposals that could provide simpler, shorter and cheaper treatments for people who are at high risk of developing tuberculosis. “What we aspire [to] is to have a large menu of projects to see how these projects would work in southern Africa and in francophone West Africa, the Sahel region, probably in Asia, in Latin America. It depends,” Marmora said.

A doctor examines a tuberculosis patient in a government TB hospital in Allahabad, India, March 24, 2014. UNITAID has just launched a new multi-million dollar initiative to finance new treatments that can prevent the onset of full-blown tuberculosis.​

Tuberculosis is a highly infectious airborne disease that kills some 1.5 million people every year. The World Health Organization (WHO) estimates about one-third of the world’s population has latent tuberculosis; that is, they are carriers of the disease, but not yet infectious. About 15 percent of these asymptomatic people are expected to develop active tuberculosis. The two groups most at risk, says WHO, are children under age five and people living with HIV.

Big step forward

The treatment for TB is lengthy. It requires patients to take pills every day for between six and 36 months. The director of WHO’s Global TB Program, Mario Raviglione, says UNITAID’s decision to invest in preventive treatment marks a big step forward in efforts to end TB by 2030. “I think it would be a fundamental game changer because it is the first time we see a real move at this level of financing - using a financial mechanism such as this one to really move forward… This will have a huge impact in preventing the onset of tuberculosis for millions of people as well as averting deaths because once you prevent, you do not have the disease and you do not have the death, of course,” he said.

A doctor points to an x-ray showing a pair of lungs infected with TB (tuberculosis) in Ladbroke Grove in London, England​

Raviglione added he hopes UNITAID’s financing will drive the pharmaceutical industry to develop better, cheaper, and shorter regimes for the prevention of tuberculosis.

New Initiative Spotlights TB Prevention in Latent Carriers

See also:

World Unprepared To Cope With Emerging Infectious Diseases
May 23, 2016 — The director-general of the World Health Organization, Margaret Chan, warns the world is not ready to cope with the threats posed by emerging and re-emerging infectious diseases. Chan told some 3,500 delegates attending the annual World Health Assembly they must work together to overcome global health threats.

World Health Organization chief Margaret Chan told a gathering of health ministers and providers that countries could no longer work in isolation to contain infectious diseases and overcome other health threats.
Waking an old disease

She says few threats are local anymore. She says people and goods move around in this interconnected world and so do diseases.For example, she notes drug-resistant pathogens, including the growing number of “superbugs,” travel internationally in people, animals, and food. “The Ebola outbreak in three small countries paralyzed the world with fear and travel constraints….The rapidly evolving outbreak of Zika, Zika virus warns us that an old disease that slumbered for six decades in Africa and Asia can suddenly wake up, wake up on a new continent to cause a global health emergency.” The Zika virus is particularly dangerous to pregnant women as it is linked with brain abnormalities in newborn babies.

Preparing for an outbreak

Chan says outbreaks become emergencies when affected countries have weak health systems that are unprepared to deal with them. In the case of Ebola, she says the epidemic spiraled out of control in large part because the West African countries lacked the means to detect, diagnose and properly care for the patients. “For Zika, we are again taken by surprise, with no vaccines and no reliable and widely available diagnostic tests," Chan said. "To protect women of childbearing age, what can we do? We can only offer advice. Avoid mosquito bites.Delay pregnancy. Do not travel to areas with ongoing transmission.”

Victoria Topay and her children pose for a family portrait at her home in West Point, Monrovia, Liberia. The empty chairs are a symbolic representation of Victoria's late husband and family members who died of the Ebola virus​

Chan says WHO’s health emergency management system is undergoing a major reform to ensure its teams are able to respond more quickly and effectively to outbreaks and humanitarian emergencies.

World Unprepared To Cope With Emerging Infectious Diseases

 

[waltky]

Complacency Has Allowed TB to Explode...

Global Efforts to Control TB Are Falling Short
October 22, 2016 - This year's U.N. report on tuberculosis was a shocker. The World Health Organization's Global TB Report 2016 said the spread of the disease is larger than previously estimated, and that global efforts to beat it are falling far short of what is needed.

Although the overall number of TB deaths continues to fall across the globe, new data showed 50 percent more cases exist in India than previously thought, so the total number of cases worldwide has increased from 9.6 million to 10.4 million. Six countries - India, Indonesia, China, Nigeria, Pakistan and South Africa - account for 60 percent of the total number of people with TB. Dr. Eric Goosby, the United Nations Special Envoy on Tuberculosis, told VOA in a Skype interview that because of better surveillance, the numbers are more accurate. But on the other hand, he said, not all cases of TB are being counted, because many countries have outdated surveillance systems.

Scientific modeling shows that more than four million people with TB are not being treated, but no one knows where they are. This means the disease is spreading undetected. That, Goosby said, is what worries him. "TB is the threat that can be spread by an aerosolized spread: not by behavior that increases your risk, but by standing behind somebody in line who coughs and infects you with a micro-bacterium. No high-risk behavior associated with it other than [being in the] wrong place at the wrong time." Within weeks after exposure to tuberculosis, a person develops a cough, fever, night sweats, then starts to lose weight. TB usually attacks the lungs, but it can attack any organ. It kills 5,000 people a day, more than the number of people who die of malaria and HIV. "And we cannot find it in our country budgets to prioritize TB as a health threat," Goosby said. Like Ebola, tuberculosis thrives in poor communities, where people live in crowded conditions with poor sanitation and poor nutrition.

As the world learned with Ebola, diseases don't stay put. Modern travel took the Ebola virus around the world, and it can do the same with TB. Yet, Goosby said, people have become complacent about this killer disease. "Our political will has waned, and it has been de-prioritized in ministries of health as the urgent, emergent disease to respond to. As a result, we see TB beginning to increase in the number of deaths it’s causing," the U.N. official told VOA. "We are now at a death rate of 1.8 million a year, which puts TB as the number-one infectious disease killer on the planet." "We can diagnose it, we can treat it with effective anti-microbacterial drugs, and cure it in about 90 percent of cases with the current drugs that are available." The need to find and treat people with TB is urgent because the disease is developing a resistance to the the two most potent TB drugs. The WHO views drug-resistant tuberculosis as a public health crisis that needs to be stopped.

Based on WHO estimates, some 480,000 people contracted multi-drug resistant TB in 2015 - more than half of them in India, China and Russia. And most people who have multi-drug resistant TB are not getting proper treatment. As for the millions of cases that are undocumented, Goosby said, "Every country should know what their portion of that 4.3 million is, and on a geo-mapping level, map out where those new infections are, go find them, identify them and retain them in care. It’s got to be that pro-active." As the United Nations' special envoy on TB, Goosby's challenge is to get presidents and their ministers of health and finance to see how perilous the TB epidemic is. If all countries cooperate, TB can be stopped, Goosby says. The goal is to end the disease by 2030. It's a tall order, but Goosby was a player in the global effort to bring HIV under control. He says it can be done.

Global Efforts to Control TB Are Falling Short

 

[esthermoon]

The people in North Korea are dying from North Korea. Cure that disease and they'll recover quickly enough.

How?

 

[anotherlife]

How long does it take for tuberculosis to infect a man, and then how long does it take to kill him? I think tuberculosis goes on for years before it kills its host.

 

[esthermoon]

This link can be useful

tuberculosis facts, information, pictures | Encyclopedia.com articles about tuberculosis

 

[waltky]

Artemisinin can be used to treat both malaria and TB...

Study: Ancient Chinese Herb Aids Fight Against TB
December 21, 2016 - Scientists have found that a drug used to treat malaria may also aid in the treatment of tuberculosis. The ancient Chinese herb, artemisinin, has the potential to shorten how long it takes to treat TB, something that could also fight drug resistance to antibiotics.

Scientists say they don't know yet by how much time artemisinin might shorten a course of standard anti-TB drugs, but experiments in the test tube suggest that it could have a significant impact. The bacterium that causes tuberculosis can lie dormant for years before taking advantage of a weakened immune system to 'wake up' and spread. It's believed a significant portion of the world’s population has latent TB. According to the U.S. Centers for Disease Control and Prevention, one-third of the world's population is infected with TB, which killed 1.8 million people in 2015. Experts say those with the active form of the disease also harbor dormant bacteria, a state in which they are largely resistant to antibiotics. That’s why it takes six months or longer to treat TB with antibiotics.

Now, researchers at Michigan State University have discovered that artemisinin, a mainstay of malaria treatment, prevents the pathogen that causes TB from going into a dormant state, exposing more of the bacteria to the drugs. Microbiologist Robert Abramovitch is a TB expert. He notes that many people who start taking antibiotics begin to feel better in a few days, as the active bacteria are killed. So they stop taking their pills, potentially causing a resistant strain of tuberculosis to develop. “It’s the dormant bacteria that take a long time to kill," he stresses. "So if we can kill the dormant bacteria with, let’s say, artemisinin or some of the other compounds we discovered, we can maybe shorten the course of therapy, and by doing that, we can reduce the sorts of clinical behaviors that are driving the evolution of drug resistant strains.” The finding was published in the journal Nature Chemical Biology.

Liquid drops into a laboratory apparatus after the conversion of dihydroartemisinic acid to artemisinin at a laboratory at Berlin's Free University, in Berlin, Germany, Feb. 1, 2012. Artemisinin has been found to have the potential to shorten how long it takes to treat TB.​

Abramovitch says TB bacteria need oxygen to thrive. To fight the infection, the body’s immune system lowers oxygen levels. To protect themselves, the bacteria goes dormant. By disrupting the microbe’s oxygen sensor with artemisinin and five other compounds the team discovered, it doesn’t sense the change, remains active and can be killed by the antibiotics.

Until now, scientists couldn’t distinguish the silent bacteria from the active ones to know whether dormant mycobacterium were being killed by different compounds. Abramovitch and colleagues developed a strain of the pathogen that glows bright green. They found it stopped glowing after artemisinin came into contact with the mycobacteria's oxygen biosensor, presumably dying. “So we would all see this as an add-on to current therapies as a way to kill another sub-population of the bacteria during the infection,” Abramovitch said, adding that artemisinin could potentially be used with the drug isoniazid, the first line antibiotic used for the treatment of tuberculosis.

Study: Ancient Chinese Herb Aids Fight Against TB