Khaama Press (07.31.2013)
According to the World Health Organization (WHO), Afghanistan reported 10,500 TB deaths annually, making it one of 22 countries with the highest TB burden in the world. WHO also reported that Afghanistan diagnosed 53,000 new TB cases annually. The majority of new TB infections (66 percent) occurred among women, and children accounted for 10 percent of new TB cases. Experts attributed Afghanistan’s high TB incidence to poverty, inadequate working and living conditions, lack of access to healthcare and medications, security issues, and lack of TB awareness. Many Afghans believed that TB was incurable.
Afghanistan has had some success in implementing the Directly Observed Treatment Short Course (DOTS) strategy to treat TB. Ninety-seven percent of Afghans had access to DOTS in 2011, compared with 14 percent in 2002. Close to 1,200 Afghan health facilities offered DOTS in 2011, compared with 10 facilities in 2000. DOTS implementation required sustained resources to ensure diagnosis by sputum-smear microscopy, short-course anti-TB treatment under direct observation, an uninterrupted supply of high-quality TB medicines, and standardized reporting.
Based on DOTS successes, WHO developed the “Stop TB Strategy” to address six challenges countries face in eliminating TB globally: sustaining and expanding DOTS; addressing TB/HIV coinfection, multidrug-resistant TB, and other special challenges; strengthening health systems; engaging healthcare providers; empowering patients and communities; and promoting TB research.
Since the majority of Afghans live in rural areas and have little understanding of TB, Afghan experts also recommended the country develop a national TB communication strategy to increase TB awareness and promote TB-safe behavior. Research methods used in developing the communications strategy should include knowledge, attitude, practices, and beliefs; focus groups; and participatory rural appraisal techniques. Research also should focus on women and girls, who traditionally carry out household tasks in unhygienic environments and have higher TB burden.