‘Ambient air pollution can increase risk of TB’

Bangladesh ranked sixth among high TB burden countries.

Tuberculosis (TB) is an airborne disease; common symptoms include cough with sputum and blood in some cases, chest pains, weakness, weight loss, fever and night sweats. TB can lead to the death of an infected person when left untreated. Sputum examination is the only reliable way to diagnose this disease. It is a communicable disease and an infected person can infect up to ten others if not treated.

In an interview with the Business Eye, Assistant Director of 250 Bed TB Hospital Ayesha Shilpi said we must not forget that tuberculosis in Bangladesh remains a serious public health problem. Bangladesh ranked sixth among high TB burden countries.

She said: "Every citizen of the country should remember that we are living in a tuberculosis prone area considering the region. Even though the life expectancy of people is increasing, many people have medical complications related to diabetes or old age. Indoor air pollution is increasing in both the rural and urban areas as open space is decreasing. Ambient air pollution increases the risk of tuberculosis. Delay in diagnosis has also become a big challenge."

Bangladesh has attained more than 90% treatment success and more than a 70% case detection rate. Despite these successes, tuberculosis in Bangladesh remains a serious public health problem.

Asked about the main reasons, Dr Ayesha said: "Tuberculosis cannot be controlled for several reasons. Poverty is one of those. Due to poverty, many hide the symptoms of the disease. Low income people or people like day labourers think that visiting hospitals for treatment will cause them financial harm as they will not be hired for work anymore. They are hiding or ignoring the symptoms of TB and thus are spreading the disease among others."
"As a dense populated country, public transport in our country is overcrowded and if there is a TB patient in that crowd, he can infect many people," she added. 

Regarding Pediatric tuberculosis, she said: "Childhood tuberculosis is under-reported in Bangladesh due to difficulties in confirming diagnosis. But now we have machines and methods."

"Actually, children under five don’t really caugh like that of TB infection. So, most of the know ds with TB infection remained undetected.  The proportion of childhood TB among all reported cases is only 3.35% considerably lower compared to other high-burden countries," she added. 

Regarding TB treatment, she said: "Effective treatment of TB includes investment in medicine, local health services and diagnostics. To ensure full recovery, social protection of patients is also required."

Multidrug-resistant TB (MDR-TB), for instance, requires two months of drug treatment and a four month continuation period. The application of a more successful method will help in curing the most complex TB cases, such as drug-sensitive TB, she added.
"With the implementation of proper and effective treatment strategies, we can eliminate tuberculosis in Bangladesh and the benefit even the poorest members of society,"said Dr Ayesha. 

Asked about Asthma, she stated that in Bangladesh, it appears to be a substantial public health problem: an estimated 7 million people including 4 million children suffer from asthma-related symptoms.

Asthma is a chronic lung disease affecting people of all ages. It is caused by inflammation and muscle tightening around the airways, which makes it harder to breathe. Symptoms can include coughing, wheezing, shortness of breath and chest tightness. These symptoms can be mild or severe and can come and go over time.
While people with asthma often experience a whistling or wheezing sound in the chest in addition to coughing, there are many types of asthma in Bangladesh.

Severe asthma: The airways of the lungs suddenly constrict and cause difficulty in breathing.

Allergic asthma: Allergic asthma, sometimes called atopic asthma, is asthma triggered by allergens like pollen, pets, and dust mites. About 80% of people with asthma have allergies.

Long-term asthma: Some people have asthma that only flares up at certain times of the year regularly. 

Non-allergic asthma: Non-allergic asthma, also known as non-atopic asthma, is asthma that isn’t related to an allergy trigger like pollen or dust. It’s less common than allergic asthma. Non-allergic asthma often develops later in life.  
Asthma medicines are of two types--reliever and preventer. Salbutamol, Terbutaline, Theophylline, Bambuterol etc. are used to treat Asthma, she added.

She said if the medication is taken according to the correct rules, it can be controlled. In some cases, a nebulizer may be needed. If inhaler is used according to the doctor's prescription, it will be under control for those who are allergic due to genetic reasons.