TB is rife in Kyrgyz prisons and inmates are exposed to higher risk of contracting the infectionArslan Baitikov, 43, is a well-off entrepreneur in Kyrgyzstan. He does not seem the kind of person who might get tuberculosis (TB), which is believed by local doctors to be more of a disease of the poor. Worse still, he suffers from multi-drug resistant TB (MDR-TB), which is very difficult to treat.
For three months now he has been at the National Centre of Phthisiology (NCP - for treatment of pulmonary diseases) in Bishkek. He takes 16-18 pills a day and is on a drip. If he wants to recover he will have to endure the treatment for two years. Doctors say only a few patients complete the full treatment course.
According to the World Health Organization (WHO), MDR-TB is a specific form of drug-resistant TB which contains a bacillus resistant to isoniazid and rifampicin, the two most powerful anti-TB drugs.
There are currently 1,400 cases of MDR-TB in Kyrgyzstan, NCP doctors say. However, only 600 are receiving treatment, which costs about US$7,000 per patient - a large sum in a country where the average annual salary in the civil service is around $1,600 (source: Kyrgyz statistics agency).
According to the US Agency for International Development (USAID), Kyrgyzstan has the sixth highest rate of MDR-TB in the world.
Preliminary results from a small sample drug resistance survey in 2007 in Bishkek estimated MDR-TB to be running at about 16 percent of new TB cases. Of all the new MDR, cases 54 percent had undergone some TB treatment in the past. The survey, however, is not a good indicator of MDR-TB nationally, and USAID and the Centre for Disease Control and Prevention may support a national drug resistance survey to better estimate the true extent of the problem.
Global Fund
Head of Department of MDR Pulmonary TB in the NCP Atyrkul Toktogonova said the treatment of patients was free thanks to funding from the Global Fund to Fight AIDS, Tuberculosis and Malaria. “The procurement of expensive medicaments is done by the Global Fund,” she said.
The Global Fund provides laboratories with the necessary equipment, and diagnoses patients. It funded the refurbishment and procurement of specialist equipment for NCP’s Department of MDR Pulmonary TB, and very soon plans to open two MDR departments in the south - in Osh and Jalal-Abad - and has earmarked about $10 million for the purpose.
“It is necessary to treat every infected person by any means,” said Toktogonova. “I think if one infected person is not treated, he/she will infect 15 healthy people. And then the disease might grow exponentially.”
Dinara Sagynbaeva, head of the Health Ministry’s department for the provision of medical care, said: “Despite the fact that the government of Kyrgyzstan is taking all measures to fight tuberculosis, this dangerous disease remains one of the major problems in the country.”
Disease rife in prisons
She believes the number of people with TB keeps growing also because many of the infected are prison inmates.
The risk of contracting TB in the penitentiaries is forty percent higher than the risk in general population, Eva Gerber-Glur, an International Committee of the Red Cross (ICRC) official, told IRIN.
ICRC figures indicate that 300 inmates have MDR-TB in Kyrgyzstan.
“The usual form of TB can lead to the resistant form if a diseased person stops taking the correct medication. There are also resistant tubercle bacilli in Central Asia - due to the fact that after the collapse of the Soviet Union, there was no proper care,” she explained.
Overcrowding and poor ventilation in prisons and the fact that almost all inmates are from poor and disadvantaged families means they are particularly vulnerable to TB, she said.
Disclaimer:This material comes to you via IRIN, the humanitarian news and analysis service of the UN Office for the Coordination of Humanitarian Affairs. The opinions expressed do not necessarily reflect those of the United Nations or its Member States.
Photo: Copyright IRIN
