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Min of Health -TB on The Rise; Two Patients Escape Isolation

by: - February 26, 2020
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(L-R) Dr Portia Meade, Dr Shalauddin Ahmed , Dr Irvin McIntyre, Dr David Johnson

The Ministry of Health is reporting an uptick in the number of tuberculosis cases for the year so far.

Tuberculosis is a disease caused by bacteria called Mycobacterium tuberculosis. The bacteria usually attack the lungs, but they can also damage other parts of the body. Tb spreads through the air when a person with TB of the lungs or throat coughs, sneezes, or talks.

The Ministry briefed the press on Friday, February 21st to reveal that compared to 2019’s numbers, 2020 is so far causing concern.

Hon Health Minister, Dr Irvin McIntyre listed 8 confirmed, 2 suspected and 0 deaths for last year in patients aged 27 to 82.

For the year so far, the health authorities are noting 12 confirmed cases, 6 suspected and 0 deaths in patients aged 33 to 92.

He says most of those cases were identified in the Roseau Health District.

Dr McIntyre detailed, “The Ministry can confirm that…all the patients are on anti-tubercular treatment. There are no cases of drug resistant TB at this time which makes it much easier for patients to be treated and for better recovery.

“Like other diseases, once identified, the Ministry has an obligation to implement necessary measures that will prevent or reduce the spread of these infections…which also includes suspected cases. Control measures have been implemented both at the primary healthcare level and the secondary or hospital level.”

The Health Minister specified that these measures include ensuring that all patients diagnosed with tuberculosis who are admitted to the hospital are placed in isolation and/or wear facemasks.

He says there is an isolation area to house confirmed TB patients.

Meantime, at the community level, Dr McIntyre says, contact tracing continues to identify and test people who may have come into contact with the index patient(s).

Furthermore, more treatment medication has been secured to avoid a stock-out, and health workers have been educated.

Testing for TB in Dominica at this time takes three stages. The first is that of identifying the symptoms of the disease which include coughing that lasts three or more weeks, bloody or sputum, chest pain, or pain with breathing or coughing, unintentional weight loss, fatigue, fever, night sweats, chills or loss of appetite

Dr Portia Meade, part of the management team at the Dominica-China Friendship Hospital with responsibility for tuberculosis, named the other stages.

She explained, “The patients’ lungs would then be examined by the physician who is looking for areas that would suggest an infection in the lung. After that, the investigations would carried out. One of the main things would be a blood test to check the white blood cells, we also check the liver and kidney function Another test is the erythrocyte sedimentation rate which indicates the level of infection that the patient has.”

Dr Meade went on to list, “The sputum test is done: the collection of whatever the patient brings up after coughing. This is done on three consecutive days and that is where we look for the tuberculosis bacteria.”

The skin test is finally done and then the patient is isolated.

Currently, the results come from overseas but Hon Health Minister, Dr Irving McIntyre says within the next two months, gene expert testing will be available to test and diagnose faster.

National Epidemiologist, Dr Shalauddin Ahmed assures that the increase in cases was identified promptly leading to the immediate commencement of treatment.

The Chief Medical Officer, Dr David Johnson, however, assures that there is no reason to panic.

“TB is not something which is unique to Dominica. In fact, according to the World Health Organisation, one quarter of the world’s population is infected with tuberculosis and only a small proportion of those infected will actually become sick,” Dr Johnson said.

The World Health Organization as saying that in 2018, an estimated ten million people fell ill with tuberculosis worldwide.

“In all countries,” he said. “Even in the richest countries on earth, there is tuberculosis.”

The treatment regime for tuberculosis involves 6 months of anti-TB medication.

All testing and treatment are free of charge to patients and PAHO/WHO are said to be in close contact and are guiding the process.

The authorities say they do not believe there are any active TB cases outside of those in isolated care.

Dr McIntyre says contact tracing has been done for all the index cases and are responding well to treatment.

Meantime, two TB patients have absconded from treatment at the hospital and as of Friday, had not been found.

“Dr McIntyre reported, “There were two Haitians on the ward in isolation and…I think they absconded, they left.”

He said discharge would not have been allowed.

“We have special protocols regarding this. We know exactly when those patients get discharged and when they get discharged, we send them to the district.

“The district health teams are aware of where those patients are so the contact tracing can continue.”

Dr McIntyre said the (law enforcement) authorities were informed of the missing patients and the search continues.

“Unofficial sources say that they could have left the island.”