OfMaria Giovanna Faiella
Every year 10 million people get sick in the world, 1.3 million die. Since 2000, 75 million lives have been saved. Some good Italian practices. Girardi (Spallanzani): «In Italy it is possible to eliminate tuberculosis as a public health problem». that's how
Every year, around the world, 10 million people get sick from tuberculosis;
one million three hundred thousand lose their lives. Yet, this infectious disease can be done today prevent and cure. According to data from the World Health Organization, there have been since 2000 saved 75 million lives, thanks to the efforts made to fight it globally. This is why, on the occasion of World Tuberculosis Day, which occurs on March 24, the theme chosen by the WHO is «Yes! We can end TB!» (Yes! We can put an end to tuberculosis”), a message of hope but also an invitation to intensify the fight against the disease until it is eradicated by 2030one of the Goals of the United Nations Sustainable Development Agenda.
Eliminating TB in Italy is a possible goal
«In countries like Italy (there are over two thousand cases a year ed) eliminate tuberculosis as public health problem it's a possible goal and which requires a renewed commitment – underlines Dr. Enrico Girardi, scientific director of the National Institute for Infectious Diseases IRCCS Lazzaro Spallanzani of Rome, in a video (here) released on the occasion of the world day – . Our Institute is working to contribute to this ambitious objective along several lines: guaranteeing a rapid diagnosis and appropriate treatment for people with tuberculosis; guarantee to those who have had aexposure or are at risk of tuberculosis interventions to prevent the infection from progressing to disease; contribute to developing new tools through research for the control of tuberculosis for better diagnosis, for better therapy, for a better outcome for patients”.
Adds Delia Goletti, director of Translational Research at Spallanzani: «In the world two billions of people have a latent tuberculosis infection and of these about the 10% will develop the disease but, at the moment, we have no tools to identify them in advance. Spallanzani's translational research group has demonstrated the presence of tuberculosis mycobacterium in CD34+ blood cells of patients with latent tuberculosis infection. These cells could represent niches where the bacterium hides and then reactivates. The results of these studies will allow us to arrive at precision medicine to identify those who are at greater risk of developing the disease in the future and to draw targeted therapies to prevent them from getting sick and spreading the infection themselves. It is important to continue investing in tuberculosis research.”
In some countries, poor services, poor information, stigma
A few decades ago tuberculosis seemed unbeatable; Today it can be prevented and treated. Why can't we eradicate it?
«In some countries it is not possible to eradicate it for a series of reasons – says Daniela Cuomo, head of planning and initiatives on the territory of the Global Center for Mutual Development (CMSR), one of the Civil society organizations adherents to Italian Global Health Network who are carrying out projects for the prevention and treatment of TB in the areas where it is most widespread -. In some African statesfor example, a series of problems add up: from lacking or poorly equipped health facilities – sometimes even without electricity and drinking water -, at the poor information on how TB is prevented and transmitted, up to treatments that are paid for (they are free only in some countries). And then, there's the fear of stigma which still exists in relation to those who have tuberculosis or AIDS, so those who are affected do not talk about it so as not to be isolated; so the chain of contagion continues.”
Hence the importance of disseminating correct information and, at the same time, supporting fragile health services. One of the projects aimed at eradicating tuberculosison the territory, through better diagnosis and treatment services and training of local operatorsthis is what the CMSR is doing Tanzania, in the Dodoma region, involving more than twenty villages in the Kondoa district. It was financed by the Italian Agency for Development Cooperation through the “Announcement 5% Global Fund” , that is, one of the mechanisms by which the Italian Cooperation supports the actions of Global Fund to fight AIDS, Tuberculosis and Malaria, implemented in the beneficiary countries.
Italian projects in Tanzania
Daniela Cuomo explains: «We operate on two levels: the first is raise awareness of tuberculosis, therefore how to prevent it, how to treat it and why it is important to talk about it; we do it above all through the formation of the so-called Community Health Workers, i.e. community workers who also have the task of identifying cases of tuberculosis in the various villages and supporting patients in taking the therapies correctly. Another activity that we carry out, in collaboration with the local authorities – continues the manager of planning and initiatives in the CMSR area – consists in trying to improve basic health services, so that they have a greater ability to identify suspicious cases, also through the tools necessary for diagnosis, such as microscopes and others. If you think about the health services of a country like Tanzania– Cuomo underlines – must be considered that at a local level the reference points are the dispensariesa sort of small clinics that serve 4-5 villages, even very distant from each other. I am structures that are often very dilapidatedeven without running water and electricity, so first we need to activate the essential services to make them operational, then we try to make them autonomouswith personal able to provide medicines in less serious cases, follow patients even by going to the villages. And, to facilitate travel from one village to another, often difficult to reach due to the lack of means of transportwe gave them the bicyclesas well as smartphones for facilitate communications with other local healthcare facilitiessuch as more equipped centers where patients who need to have more in-depth analyzes can be sent, and local hospitals where the most seriously ill can be sent.”
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