Expert: “Tuberculosis hotspots are always where there is poverty” | Sunday paper

“Not all infected people develop symptoms.”

Almost everyone has heard of “tuberculosis”, some know that the disease was colloquially called “consumption”. But what exactly is behind it and how does the disease manifest itself?

Christa Kasang: Tuberculosis is a bacterial infection that is transmitted via droplets and, if it breaks out, attacks the lungs. This makes breathing more difficult and leads to the classic symptoms, such as a long-lasting cough, night sweats and weight loss. Hence the name consumption. However, not all infected people develop symptoms. It is estimated that up to a quarter of the world’s population is latently infected with TB, but most outbreaks of the disease occur when the immune system is under stress. In addition to the lungs, other organs can also be affected, such as bones or the skin.

There are hardly any tuberculosis cases in this country – and if there are, the patients are isolated immediately. Where are the global hotspots and what is the biggest challenge in treatment?

Basically, one can say that tuberculosis hotspots are always where there is poverty and people live in cramped conditions. Geographically, India, Indonesia, China, the Philippines and Bangladesh are most affected, followed by Nigeria, Pakistan and South Africa. The disease is treated with four different antibiotics. Unfortunately, there are now resistances to this, which makes therapy extremely difficult. This multidrug-resistant TB is also common in India, but also in Eastern Europe. Fortunately, there is a new antibiotic that can be used, but the treatment is expensive and takes a long time.

“Active case finding means we’re diagnosing people who wouldn’t normally see a doctor.”

The German Leprosy and Tuberculosis Aid relies on so-called “active case finding”. Can you explain that in more detail and explain it with some project examples in the Global South?

Active case finding means we diagnose people who would not normally see a doctor. We at DAHW, for example, carry out active case searches very successfully with truck drivers in India who, due to their high level of mobility, cannot integrate well into the normal healthcare system. In another project in Tanzania, community workers are involved – these people can identify those affected within the communities at an early stage and then arrange for diagnostics and therapy. And we are also actively looking for cases in prisons, for example in Ethiopia.