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Stigma for tuberculosis in Tumaco produces high under-recording

An exemplary campaign is being held in Tumaco which hopes to scare away infection phantoms and public disgrace created by this disease.

Bogotá D. C., 03 de febrero de 2014Agencia de Noticias UN-

Tumaco has approximately 190,000 inhabitants.

La multi-drug resistance is one of the consequences of the lack of follow-up on tuberculosis treatments.

There are approximately 12,000 tuberculosis cases a year in Colombia.

Under-recording is one of the most worrisome aspects in controlling and preventing tuberculosis in Tumaco (Province of Nariño).

The Tuberculosis/HIV relationship in Tumaco has increased.

Providing information and education are key aspects in tuberculosis prevention and treatment.

UNal Professional Nurse Carlos Andrés García, discovered an opportunity in this coastal city of the Province of Nariño to develop a “Tuberculosis Program Indicator Assessment in the Municipality of Tumaco”, carried out with the support of the Administrative Department for Science Technology and Innovation (Colciencias, for its Spanish acronym) and in line with the Tuberculosis Program in Colombia. 

The myths and stigmatization, inclusively amongst physicians, have contributed to increase the amount of patients transferred for treatment and abandonment. And add to the aforementioned the invisible barriers created by the armed conflict. 

García highlights aspects such as the fear of being identified and separated from the community which plays against those who are suspected of having tuberculosis and do not report it. 

Some data such as a 45% under-recording of some of the cases associated with HIV is just an example. 

Precisely the Tuberculosis-HIV association known as coinfection has turned into an alarming sign. From 4% of the cases in 2010, it jumped to 10% in 2011, according to data provided by Garcia’s research. 

“If the community speaks in hushed tones about tuberculosis, the situation turns even more dramatic when it is linked to HIV. A breeding ground for this phenomenon is prostitution growth. 

Communicate and educate 

After socializing the project with the Office of the Municipal Health Secretary and the promoters of the Local Tuberculosis Program, García joined the daily work activities performing urban and rural outings, interviews and permanent measurements. 

This is how he discovered that in this small and tumultuous city which harbors close to 190,000 inhabitants, the warmth and solidarity of its dwellers contribute to a good comprehensive healthcare and particularly to treating 154 cases recorded between 2010 and 2012. 

He also discovered that the respiratory symptomatic detection percentage reached and surpassed 100%. 

“The program has a large team of technicians which move daily through the streets in search of people which have been coughing for more than 15 days. They also travel around rural settlements and gather a bacilloscopy sample, which has allowed having a very high detection level”, said García. 

Another aspect highlighted by the researcher is the commitment from the workers. At an urban level there are 8 healthcare posts; 16 rural and 20 close to the coast and rivers. The Divino Niño Hospital is the state health-care institution (ESE, for its Spanish acronym) of Tumaco and has 44 facilities. 

One suggestion of the research project is to report and educate. Essential information provided is that a patient in treatment ceases to be a risk after 25 days. 

“Transmission carried by the air by coughing, laughing o talking is easily controllable if medical prescriptions are followed”, says Healthcare for the Underprivileged Director and Professor of the UNal School of Nursing Alba Idaly Muñoz, which García joined during his junior year when he began this research project. 

Regarding the risk of death, it is scientifically proven that tuberculosis is curable but it is essential of strictly follow treatment guidelines. 

Some figures on tuberculosis 

According to data of the World Health Organization (WHO) every year 9 million people are infected by tuberculosis, while 2 million die for the same reason. 

In Colombia there are 12,000 cases reported a year. Although the gap between estimated incidence and reported is increasingly less and in the last few years it has remained steady (between 24 and 26 cases for every 100,000 inhabitants). 

The provinces of Antioquia, Valle del Cauca and Bogotá provide almost 40% of the new tuberculosis cases in the country. 

Every year 1,000 tuberculosis deaths are reported, despite that, the mortality rate has reduced to close to 40%. 

In 2012, HIV voluntary testing coverage reached 61% of the patients with tuberculosis, discovering more than 1,000 cases of TB/HIV coinfection, representing a percentage of 11%. 

(Por: Fin/DMH /SUP
)
N.° 907

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