COTE D'IVOIRE: Tuberculosis infections spreading

Tuberculosis (TB) infections in Côte d’Ivoire increased 9 percent between 2006 and 2008, and almost 10 percent of the cases were multidrug resistant, according to new World Health Organization (WHO) and Ministry of Health data.

“The total increase corresponds to an increase of 23,000 cases detected,” said Jacquemin Kouakou, director of the anti-tuberculosis unit at the Health Ministry.

In 2005 there were 18,000 cases of TB in Côte d’Ivoire, rising to 21,000 in 2006, the last time data was available. “The situation is very worrying,” Kouakou said.

TB is a contagious disease spread through the air. One third of the world’s population is believed by the WHO to be infected, but the disease lies dormant in most people until their immune system is weakened.

The co-infection of HIV and TB is one of the principal causes of the disease’s spread in Côte d’Ivoire, the ministry said. It has calculated that 39 percent of people infected with TB are also infected with HIV. TB and HIV together form a lethal combination, each speeding the other’s progress.

Multidrug resistant TB

Côte d’Ivoire was revealed by a separate WHO survey released on 26 February to have a high level - 9 percent of all cases - of multidrug-resistant (MDR) TB, a hard-to-treat strain of the disease caused by inconsistent or partial treatment, when patients do not take all their medicines regularly for the required period, because doctors and health workers prescribe the wrong treatment regimens, or because the drug supply is unreliable.

MDR-TB is generally treatable but it requires extensive chemotherapy and more expensive drugs over a long duration. High rates of MDR-TB threaten global TB control efforts, according to the WHO.

It is estimated that 1.6 million deaths resulted from TB in 2005. The largest number of new TB cases occurred in Southeast Asia. However, the estimated incidence rate in sub-Saharan Africa is nearly twice that of Southeast Asia, at nearly 350 cases per 100,000 people, the WHO estimates.

Both the highest number of deaths and the highest mortality per capita are in Africa. “The TB epidemic in Africa grew rapidly during the 1990s, but this growth has been slowing each year, and incidence rates now appear to have stabilised or begun to fall,” WHO says.