Latin American Report

Education: Latin America Gets Poor Mark
(8/4/1999)

Curable Diseases Go Untreated

By Néfer Muñoz

SAN JOSE, Aug 2 (IPS) - Pneumonia, measles and tuberculosis are curable diseases, but continue to be problems for Latin America. Without immediate action, more dangerous strains of tuberculosis, for example, will accompany the region into the new millenium.

The Pan American Health Organisation (PAHO) reported that throughout Latin America and the Caribbean more than 400,000 people are infected with tuberculosis each year. ''This public health threat has not diminished in the 1990s,'' stated George Alleyne, PAHO medical director, in a report released in the Costa Rican capital.

The PAHO also reports that the principal causes of death for children under age five in the region are respiratory infections (such as pneumonia), diarrhea and malnutrition.

On a positive note, thanks in part to a joint effort by the PAHO and the U.S. Centre for Disease Control (CDC), measles is on the verge of being totally eradicated in the region.

But every year, pneumonia claims the lives of nearly 100,000 children under age five in Latin America and the Caribbean. Most deaths could have been prevented by early recognition of simple clinical symptoms and inexpensive antibiotics, said Gabriel Schmunis, a PAHO medical expert on transmitted diseases. Lack of access to medical services, and the scarcity of appropriate antibiotics for treatment - or their misuse - are some of the factors contributing to the high mortality rates for acute respiratory diseases, says the PAHO report.

In the case of tuberculosis, however, people who are infected do not necessarily get sick. The immune system can envelope the tuberculosis bacteria and the disease may remain latent for years. It is an infectious disease caused by mycobacterium tuberculosis, an airborne germ that is transmitted when an infected person coughs, sneezes or speaks. An individual with active tuberculosis who is not undergoing treatment will infect 10 to 15 people per year on average. Of every 10 people infected with tuberculosis, one contracts the disease. For those who contract the disease and do not receive treatment, mortality rates can be as high as 50 percent. According to recent statistics, more than 50,000 people per year, or 137 per day, die in the Americas from tuberculosis. In 1997 alone, some 253,000 cases of tuberculosis were reported in the region.

''The situation could worsen in some countries unless they accelerate efforts to control it,'' maintained Alleyne.

In Canada, Chile, Cuba, the United States and Uruguay, reports show that the number of cases is falling. However, the PAHO is concerned about inadequate reporting systems in countries with limited resources like the Dominican Republic, Ecuador, Haiti and Honduras.

When the immune system is in a weakened state, a person is more likely to contract the disease. Reports show that tuberculosis currently kills more young people and adults around the world than any other infectious disease.

''In the Americas we have eradicated poliomyelitis and we are on the road to eliminating measles, to the extent that we are concerned that some countries have not made the same commitment to controlling tuberculosis,'' stressed Alleyne.

According to 1997 data, the number of reported tuberculosis cases in Mexico per 100,000 inhabitants reached 23.6, in Argentina it was 12.4, in the United States - 19.8, and in Peru it hit 42.1 per 100,000 people.

The PAHO has recommended that the region's governments adopt a public health strategy known as Directly Observed Treatment, Short- Course (DOTS). Under DOTS, health workers and trained volunteers work with tuberculosis patients to make sure they are consistently taking their medication. The strategy involves five basic points: political commitment, case detection, short-term treatment, providing medications and a follow-up system.

The PAHO plans to control tuberculosis, and its goal for the end of this year is to identify 70 percent of all new infectious cases and to successfully treat at least 85 percent of them.

''More than 80 percent of treated cases in the region using the DOTS method were successful. This contrasts with the success rate for other treatments of 33 percent,'' stated Rodolfo Rodriguez, regional adviser on tuberculosis for the PAHO.

In the Americas, 22 countries have adopted the strategy, and pilot plans have been launched in Brazil, Ecuador, El Salvador, Haiti and Honduras. This work is part of the plan the PAHO implemented in the region with national governments, the World Bank, several non- governmental organisations and the CDC.

The PAHO study shows that numerous risk-factors - demographic, social-economic, environmental, food-related, and behavioural - determine whether or not pneumonia, tuberculosis and other diseases are health problems that such programmes can control.

[c] 1999, InterPress Third World News Agency (IPS)
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