Prolonged coughng may be due to TB

KUALA LUMPUR: Prolonged coughing for over two weeks, with blood-containing sputum, fever, night sweats, and poor appetite causing weight loss should not be mistaken as a case of poisoning or black magic spell.
The condition may be due to tuberculosis (TB), an infectious disease usually caused by the bacterium, Mycobacterium tuberculosis.
Public thinking that coughing up blood could be due to "santau" (poisoning coupled with magical incantations and executed through physical means or through the wind) needs to be corrected. This is because the tuberculosis diagnosis is based on detection of the bacteria in the sputum sample given by the patient.
According to Health deputy director-general (Public Health), Datuk Dr Azman Abu Bakar, death cases at the government hospitals due to diseases of the respiratory system, including TB, constitute the second highest number among the diseases that caused death at these hospitals.
"It (TB) has become a public health issue. Although Malaysia is heading towards becoming a developed nation in two years, we are still facing this problem," he said when met after the opening of the National TB and Lung Diseases Conference 2018 recently.
In Malaysia, 26,168 TB cases were reported in 2017, an increase of 8% from 24,220 cases in 2015. The death rate due to TB also rose to 6.5 for every 100,000 of the population last year from 5.5 for every 100,000 people in 2015.
The World Health Organisation (WHO) estimated that there were 10.4 million TB cases worldwide in 2016, with 1.3 million deaths caused by this disease.
Azman said although modern medicine had become more advanced, the number of TB cases had increased because patients were late in seeking treatment.
In some cases, besides the lungs, the bacteria can also attack the brain, heart, spine, lymph nodes, adrenal gland and intestines.
"People should check their health status at the nearest clinic or hospital if they have symptoms of the disease. TB can be treated and the most important thing is for patients to strictly follow the schedule and dosage of medication set by the doctor.
"As TB is spread through the air, patients should be responsible and take precautionary measures to prevent the disease from spreading to others. They should also observe personal hygiene and wear a face mask.
"Besides that, TB patients must also complete their treatment as the period of taking the medication is at least six months," he advised.
"They must complete the treatment because if they stop taking the medication once they feel healthy again and not coughing, they can have multiple drug resistant tuberculosis (MDRTB), that is, being resistant to the first drug, hence they need to take a second drug and the oral treatment takes longer, 18 months to two years,|" he added.
The treatment for TB patients is free at the government hospitals, while the government spends RM250 on the six-month treatment cost per patient.
According to Azman, this cost is very low compared to the treatment for MDRTB, which is at RM8,000 to RM16, 000, while treatment for extensive drug resistant TB (XDR-TB) could reach RM100,000.
He said the government was very committed to ending the TB epidemic in this country by carrying out various efforts, including early detection through screenings and contact inspections.
"TB infection can also be prevented through immunisation with the Bacillus calmette-guerin (BCG) vaccine, which is free for newborn babies, and the isoniazid preventive therapy for tuberculosis prophylaxis among people living with HIV/AIDS and for children aged under five years who are in contact with TB patients."
Azman also advised parents to ensure that their children are given the BCG vaccination as some parents have refused the vaccination for their children.
The Health Ministry recorded 674 cases of parents who declined to give their children the BCG vaccination.
"It's not that difficult to prevent or treat TB. Unfortunately, there is the anti-vaccine group that does not believe in immunisation. We hope they will think back and opt for vaccination of their children to prevent them from contracting TB," said Azman.
However, he added, the increase in TB cases was not just due to the anti-vaccine movement but also the lack of awareness of the prevention methods, weaknesses in managing cases and contacts, delay in seeking treatment and the influx of foreign migrants whose vaccination status were unknown.
Azman said efforts would continue to ensure Malaysia could be free of TB by 2035 and he hoped that all parties could cooperate with the government in meeting this goal.
This year, World TB Day falls on March 24, while the national-level commemoration of World TB Day and World Leprosy Day was held on March 6. — Bernama