According to the World Health Organisation (WHO), the only way to eliminate micro bacterial TB by 2050 is to diagnose and treat any case of latent infection.
The incidence rates of TB in the UAE remain relatively low in comparison to other regions. However, migration and immigration of people from surrounding countries where TB infections are highly prevalent means that these figures are on the rise.
The current chest x-rays used by the health authorities to screen the thousands of migrant workers flocking into the UAE on a daily basis will only diagnose when a person is actively infected with TB. The problem is that those with the latent infection go undetected and when re-activated, this infection can quickly spread among the population in the UAE.
Health authorities are currently looking at ways to increase the efficiency of mass screening methods to detect latent TB infection and also, to enhance the logistics of the testing in order to cut down the waiting time for conclusive results.
Speaking at the 1st Middle East Infectious Diseases Update for Physicians Conference, part of the Patient Safety Congress at the Abu Dhabi Medical Congress, Dr Luca Richeldi, director of the Research Centre for Rare Lung Diseases at the Universita Degli Studi Di Modena E Reggio Emilia in Italy, discussed the worldwide re-emergence of TB as well as the technological advances in screening methods, diagnosis, treatment and prevention of the disease.
“TB is re-emerging because of two factors; the high numbers of immunosuppressed people (such as those with HIV-infection) around the world and the increasing migration of people from high prevalence areas to those deemed as low prevalence areas,” says Dr Richeldi. “While the UAE is currently stable in relation to its TB prevalence, numbers are likely to increase because of the high number of people migrating to the country from high prevalence areas such as India and Africa.
“Another concern for the UAE must now be the regular screening of its health care professionals who are at high risk of contracting TB. It is not enough for them to be screened once as latent TB can be reactivated and become full-blown TB at any time after initial screening. With countless new hospitals and healthcare facilities being built in the UAE, the concern for the safety of health care workers should be given serious consideration.”
For Dr Richeldi, the problem lies with the unreliability of the current ‘skin test’ used to diagnose latent TB. He believes this method is out-of-date and not specific enough as the results can be confounded by the Bacillus Calmette-Guérin (BCG) vaccination. In other words, with over 4 billion people currently vaccinated with BCG, there is a high likelihood that the results of their TB testing will be compromised by the presence of the TB micro bacteria in their system.
According to Dr Richeldi, by using testing methods such as QuantiFERON-TB (QFT) diagnosing latent TB is accurate and fast. This blood test gives reliable results within 24 hours, patients are not required to revisit for further testing, the results are standardised and automated and most importantly, QFT can differentiate between actual micro bacterial TB and the effects of the BCG vaccination.”
Mr Thomas Schmitt from Cellestis, director of the commercial partners programme from the Australian company that develops and markets the QFT technology, shares Dr Richeld’s concern for the need for more accurate testing in the region.
“With over 1.5 million QFT tests carried out around the world, this method of testing for the TB infection is fast, accurate and objective,” explains Mr Schmitt. “As the UAE authorities have to deal with a vast numbers of tests on a daily basis, these new testing methods would not only revolutionise the initial screening that is conducted when obtaining your residence permit but re-testing could be introduced and standardised to protect the health of the UAE’s national and transient populations.”
Crafted by IIR Middle East, the organisers of Arab Health, the Patient Safety Congress is in its final day.
Tuesday, October 13- 2009 @ 16:00 UAE local time (GMT+4) Replication or redistribution in whole or in part is expressly prohibited without the prior written consent of Mediaquest FZ LLC.