3 November 2017

Lesotho Registers Gains in TB Fight

LESOTHO has registered modest gains in its war against the highly infectious and deadly tuberculosis (TB) disease amid World Health Organisation (WHO) revelations that the country has achieved a seven percent decline in TB incidence rates since 2010.

According to the WHO website, TB causes ill-health in approximately 10 million people each year and it is one of the top 10 causes of death worldwide.

For the past five years, TB has been the leading cause of death from a single infectious agent, ranking above HIV/AIDS.

The End TB Strategy was endorsed by WHO's 194 member states, including Lesotho, during the 2014 World Health Assembly.

The 2035 targets are a 95percent reduction in TB deaths and a 90 percent reduction in the TB incidence rate, compared with levels in 2015. The 2030 targets are a 90 percent reduction in TB deaths and an 80percent reduction in the TB incidence rate.

According to the Global TB Report 2017, Lesotho has achieved a 7 percent decline in TB cases since 2010, the second highest rate in TB burden countries.

Only Zimbabwe, at 11 percent has registered a greater decline.

Other high TB burden countries that have registered a decline are Kenya (6.9 percent), Ethiopia (6.9 percent), the United Republic of Tanzania (6.7 percent), Namibia (6 percent), Zambia (4.8 percent) and the Russian Federation (4.5 percent).

The report further states that, "from under 10 per 100 000 population in most high-income countries to 150-300 in most of the 30 high TB burden countries, and above 500 in a few countries including Lesotho, the North Korea, Mozambique, the Philippines and South Africa.

However, Lesotho still has to do more as it remains listed among top 30 burdened countries for TB for the period 2016-2020.

The report states that Lesotho is among those countries with the lowest levels of treatment coverage of 50percent or less.

Other countries listed in this category are Indonesia, Kenya, Liberia, Mozambique, Nigeria and Tanzania.

Broader influences on the TB epidemic include poverty, HIV infection, undernutrition and smoking.

"An estimated 10 percent (range, 8-12 percent) of the incident TB cases in 2016 were among people living with HIV. The proportion of TB cases co-infected with HIV was highest in countries in the WHO African Region, exceeding 50percent in parts of southern Africa.

"The risk of developing TB in the 37 million people living with HIV was 21 times higher than the risk in the rest of the world population (range, 16-27). The relative risk increases as the prevalence of HIV in the general population decreases.

"Drug-resistant TB is a continuing threat. In 2016, there were 600 000 new cases with resistance to rifampicin (RRTB), the most effective first-line drug, of which 490 000 had multidrug-resistant TB (MDR-TB).

"Globally, the TB mortality rate is falling at about 3percent per year. TB incidence is falling at about 2percent per year and 16percent of TB cases die from the disease; by 2020, these figures need to improve to 4-5 percent per year and 10 percent, respectively, to reach the first (2020) milestones of the End TB Strategy.

The report further states that, "Most deaths from TB could be prevented with early diagnosis and appropriate treatment. Millions of people are diagnosed and successfully treated for TB each year, averting millions of deaths (53 million 2000-2016), but there are still large gaps in detection and treatment".


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