INTERVIEW ? Biggest health problem facing Haiti is tuberculosis - expert

Source: Thomson Reuters Foundation - Thu, 6 Sep 2012 16:34 GMT
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PORT-AU-PRINCE (AlertNet) - A Haitian doctor who runs one of the world’s leading AIDS treatment and research centres believes the biggest single health threat in Haiti today is infectious tuberculosis (TB).

TB rates among adults are still higher than they were before the devastating January 2010 earthquake, which flattened much of the Caribbean nation, according to Jean William Pape, the doctor who heads the Haitian Group for the Study of Kaposi's Sarcoma and Opportunistic Infections (GHESKIO) in Port-au-Prince.

“Tuberculosis is the major problem in Haiti, more so than HIV,” Pape said.

“Cholera remains a problem but I think we have a way to deal with cholera.” he said, referring to a recent nationwide oral vaccination campaign against the disease.

TB is a worldwide pandemic that in 2010 infected 8.8 million people worldwide and killed 1.4 million, according to the World Health Organization (WHO). The bacterial infection destroys patients' lung tissue, causing them to cough up the bacteria, which then spreads through the air and can be inhaled by others.

GHESKIO, founded by Pape in 1982, provides around 500 TB patients free treatment every year, making it the largest provider of TB care in Haiti.

So far this year, GHESKIO has registered 781 cases of TB in adults, compared with 760 cases of the airborne disease in 2009 before the quake.

EARTHQUAKE EFFECT

Haiti had the highest rate of TB in the Americas before the quake, and the disaster has made things worse, Pape said.

In the aftermath of the 2010 earthquake, 1.5 million people made homeless by the disaster lived in makeshift tent cities, many sprawled in and around the capital Port-au-Prince.

The number of Haitians living in the camps, where crowded, unsanitary conditions create a fertile breading ground for TB transmission, has dropped to 390,000, but the lingering effects of the disaster on Haiti’s TB prevalence rates are still being felt.

“Tuberculosis is a residual of the earthquake,” Pape said during an interview with AlertNet in his office at GHESKIO’s main site in downtown Port-au-Prince.

“If you want to spread tuberculosis there’s no better way to do it than to put an infected person under a tent with other people – It’s spread by coughing and by having people in such a small environment not exposed to ventilation,” said Pape, who is also a professor at Cornell University’s Weill Medical College in New York.

Children infected with TB usually develop the full-blown disease within months, but in adults it can take months, or sometimes years, to develop, he added.

“We are almost at pre-quake rates for incidence of tuberculosis in infants,” Pape said. “But since many adults were exposed, I expect that we will continue to see a spike in the adult population, particularly because adults who are HIV infected are at 10 to 20 times more at risk to develop tuberculosis disease.”

Because the human immunodeficiency virus (HIV) that causes AIDS weakens the immune system, people with it are much more likely to be infected with TB.

The number of TB cases has fallen across the world since 2006, according to the WHO, but the disease still remains one of the leading causes of death worldwide.

 Related story: In post-quake Haiti, rebuilt AIDS clinic treats more patients