Separation is a painful, but separation because of something preventable like Tuberculosis (TB) is extremely painful. If we count the leading infectious diseases of world, then tuberculosis has always reserved its place. Worldwide, it is the 13th leading cause of death and 2nd leading infectious killer after COVID-19.As per WHO, in 2020, an estimated 10 million people fell ill with TB worldwide which included approximately 5.6 million men, 3.3 million women and 1.1 million children. In the same year, 30 high TB burden countries accounted for 86% of new TB cases and eight countries accounted for two thirds of the total. Currently, though people are being aware about the natural history of tuberculosis, its prevention and treatment strategies, however proper attitude and practice for its implementation is still a challenge. Multidrug resistant Tuberculosis, association of Tuberculosis with HIV, childhood Tuberculosis and the myths about tuberculosis still remains a public health crisis and a health security threat despite its awareness globally.
I still remember one incident few months back, when I was busy at my OPDs (Out Patient Department) in one of the renowned hospital of Nepal. I came across a patient with very disconsolate facial expression who presented with history of weight loss for 3 months, fever and cough since 10 days and blood in sputum for about a week. I counseled him for X-ray and probability of tuberculosis. Just hearing the name of disease, patient along with his two relatives were not ready to accept it as they had many misconceptions about it. This is not just one person who holds with him such unshakable myths and baseless beliefs about TB, this indeed reflects the overall scenario of our community and country as a whole. Thus it is high time to inspect these unwanted myths about tuberculosis and eradicate them from grassroot level.
The patient whom I met had a myth that he is going to die and there is no cure for tuberculosis but the fact is effective medication with proper regimen has been readily available since 1950s and lack of awareness about it is still prevalent after 70 years. Similarly there are more myths which have been hidden like an iceberg in sea. Tuberculosis is still considered a genetic disease by many and the rest who are aware that TB is an infectious disease, are half aware of the facts as they have a concept that all TB patients are infectious and they will die soon. Similarly, some have myths that tuberculosis can never happen in developed countries and it only affects people of low socio-economic status. TB is always fatal and in some villages of country like Nepal, it is considered as a curse given by God for sins. No relation between HIV and TB, transmission of TB through fomites, handshake and TB can never affect children are also some of the myths that needs to be demolished.
Hence now is the time, when we have to eradicate such myths and change people's attitudes and practice towards tuberculosis. Everyone in the community must be aware about such global burden disease. People should know that tuberculosis does not come climbing down a family tree. It is an infectious disease caused by bacteria, transmitted through microscopic droplets released in air and only one third of TB patients (mostly with pulmonary TB) who are symptomatic are infective. Tuberculosis is preventable and curable. If all patients follows complete treatment module then the death rate will be very low. It can affect people of any country irrespective of their socio-economic background and living conditions. Similarly, TB does not only happen to smokers and affects lungs but the fact is it can happen due to variety of reasons affecting brain, spinal cord, bone, intestine and even eyes. Besides this, awareness on Tuberculosis and HIV must be created in society. People living with HIV are 18 times more likely to develop active TB disease than people without HIV. As per WHO, in 2020, about 215000 people died of HIV associated with TB. Overall in the same year, 88% of TB patients known to be living with HIV were on Anti-Retroviral therapy. TB affecting only the senior citizens is also a complete misconception. Childhood and adolescent tuberculosis are equally a matter of concern and they are often overlooked by health care providers.
Thus Awareness programs can be launched from the grassroot level at our community in order to eradicate such myths on tuberculosis. A curriculum based on TB and its myths must be implemented from the school level so those upcoming generations are much aware about it. DOTS program, Muti-drug resistant Tuberculosis and the nation's effort in reducing tuberculosis should be explained to local community involving equal gender participation. It is now time that every member of our society must change their perception towards tuberculosis and bust their myths.
We should eradicate the myths starting from our family so that every family teaches the society and ultimately the whole country becomes aware. Everyone's contribution is valuable to achieve aim of WHO END TB strategy for 90% reduction in TB deaths and 80% reduction in TB incidence rate by 2030.Therefore, let us all join our hands in getting rid of all the myths about tuberculosis and take an oath to live a TB free life in coming future.
"Every breath counts and no mother should lose their child because of TB. Together we can"
"HAPPY WORLD TUBERCULOSIS DAY"