Health

T.B & Chest Diseases Institute (Under Process)

Introduction

Tuberculoses’, the biggest killer in the world has been known to man for almost 6000 years. The causative organism for tuberculoses namely mycobacterium tuberculoses has been isolated from bony fragments of Egyptian mummies dating 2400 B.C.

Tuberculoses’, is a major public health hazard and although it attacks persons from all socio-economic groups, it is widely perceived to be an indicator of poverty. What is more, it perpetuates poverty by infecting persons in their most productive years. It is a contagious disease and spreads through the air like common cold. Spreading through the air it is more infectious than aids and hepatitis. Governments alone cannot defeat TB, it requires the mobilization of all available resources, including the need of more coalition and partnerships within the communities, NGOs and the private sectors.

Global Scenario

Tuberculoses, was declared a global emergency, by WHO in 1993. It is estimated that eight million people around the world contract the disease every year, of which 95% live in developing countries. About 2 to 3 million people die from Tuberculoses every year, with the global epidemic growing and becoming more dangerous. Furthermore, the emergence of multi-drug-resistant or MDR TB is contributing to the worsening impacts of this disease. It is further estimated that between the years 2000 and 2020, nearly one billion people will be newly infected, 200 million people will get sick, and 70 million will die from TB – if control measures are not further strengthened.

Pakistan Scenario

In Pakistan, Tuberculoses continues, to take its toll of human life and suffering. Visiting his personal physician Dr J.A.L. Patel in 1946, Quaid-e-Azam Muhammad Ali Jinnah discovered that he was suffering from pulmonary tuberculoses and had less than two years to live. And although Jinnah lived to see Pakistan he did not get an adequate chance to guide its destiny, as he wanted. But for Tuberculoses the course of our national history would have been very different!

‘Pakistan’ has the 6th highest Tuberculoses burden globally and accounts for 44% of the T.B burden in the Eastern Mediterranean region, which comprises of 23 countries. It is currently estimated that there are around 2 million patients in Pakistan, while every year 270,000 new persons develop Tuberculoses.

With this premise in view and the fact that tuberculosis destroys and devastates hundreds and thousands of people each year, the Foundation For ‘Progress’ has undertaken upon itself the establishing of a Tuberculosis and chest diseases center, to provide on proper and scientific lines, a facility for diagnosis, treatment and follow up of tuberculosis patients. The aim being both the prevention and further control of this deadly disease.

Background

Tuberculoses is a contagious disease and spreads through the air like common cold. When a lung TB patient coughs, sneezes, talks or spits, germs are expelled which when inhale can cause the disease.

Spreading through the air it is more infectious than aids, hepatitis B and hepatitis C. With this premise in view and the fact that tuberculosis destroys and devastates hundreds and thousands of people each year, the Foundation For ‘Progress’ has undertaken upon itself the establishing of our tuberculosis and chest diseases center to provide on proper and scientific lines facility for diagnosis, treatment and follow up of tuberculosis patients. The aim being both the prevention and further control of this deadly disease.

About Us

The ‘Progress’ TB & Chest Diseases Center, is dedicated to helping patients, their families and the communities overcome tuberculosis through its work at the grassroot levels by TB’s screening services, by facilitating and supporting community action and government through maintaining services essential for TB control, by incorporating, community DOTS and integrating DOTS in ongoing program activities, in health related areas like HIV/AIDS as well as by influencing policies and practices affecting the diagnosis, treatment, prevention and control of TB. It shall function in collaboration and coordination with the national TB control program, the anti TB association and shall follow the treatment guidelines of the WHO and IUALD. It shall exchange information and carryout research activities both with the national and international TB care organizations.

Awareness

It shall also disseminate information about TB, through social workers, at the grassroots levels of the community, to identify suspected patients, referring them to diagnostic centers for a sputum smear, to ensure directly observed treatment, to dispense medications during initial and continuation phases of treatment and to follow up on TB patients during and after completion of treatment. In addition awareness on issues of sexual and reproductive health shall be provided, enabling people to become more conscious and hence empowered when making decisions on these matters.

Awareness on HIV/AIDS, the incidence of which is on gradual rise in our country and which is one of the important factor causing a resurgence of tuberculosis, shall also be carried out at the center.

Treatment Facility

It shall function as an out patient service carrying out diagnosis and treatment according to the DOTS principles through fully superimised intermittent and short course chemotherapy. The diagnostic procedures shall emphasis on high quality laboratory services ( Sputum Smear Microscopy ) supplemented by X-Ray and clinical assessment of the patients.

The ‘Progress’ TB & Chest Diseases Center, is a non profit linked to the health specially tuberculosis and lung diseases through a series of a program and services and is dedicated to helping patients, their families and the communities overcome tuberculosis through its work at the community and grassroot levels By providing TB’s screening services, by facilitating and supporting community action and governments through maintaining services essential for TB control by incorporating, community DOTS. Directly Observed Treatment Short Course (DOTS) is recommended by WHO as the best way to detect and cure infected TB patients. In addition to direct observation of treatment of the TB patients by trained health workers, DOTS is a comprehensive package requiring political commitment, microscope services, reliable drug supply and good recording and monitoring services.

DOTS is not only cost-effective but also stops the deadly cycle of infection, DOTS forms the basis of community participation, public-private partnerships and serves as an umbrella for integrating all primary health care activities.

It shall integrate DOTS in ongoing program activities in health related areas like HIV/AIDS as well as by influencing polices and practices affecting the diagnosis, treatment, prevention and control of TB.

Our Commitment

It is committed to fighting TB and infectious lung diseases and in making tuberculosis a rare lung disease is one of the most important part of the centers service, but the work never stops.

Our Vision

To develop into a center of excellence for diagnosis and treatment of tuberculosis.
To develop as a core facility for TB prevention, control and research.
To develop into a opinion leader on TB control policies.
To become a nodal agency for advocacy for TB control in Pakistan.

Our Collaboration

It shall collaborate with other institutions to learn and share experiences and to disseminate information on tuberculosis. Thereby by sharing knowledge on the latest trends on the prevention and control of tuberculosis, it advances the knowledge and technical expertise for a better TB patient management. It encourages for the collaboration and development of partnerships with all organizations, including those working in community development, advocacy, human rights, education, / all of which have a role. All are welcomed at its meetings, including first time visitors and family members of the patients.

OUR  GUIDELINES  AND WORK

‘Progress’ TB & Chest Diseases Center strictly follows the guidelines of the national tuberculosis program in regards to the diagnosis, treatment and monitoring, it also follows WHO’s policies with regard to the application of DOTS in the treatment and management of tuberculosis.

Our objective

Its objective is to achieve 85% cure rate through treatment with DOTS and a 75% detection rate through direct sputum smear positive sputum microscopy.

Our Startegy

It shall utilize all possible means follow policies and procedures, which contribute not only to an efficient diagnosis and management program, but also an affective follow up and control. This is a difficult and arduous task for which is achieved through the following:

  1. That an affective TB control demands a coordinated approach with standardized diagnostic treatment and information systems, the center shall coordinate, collaborate and follow the policies of the national tuberculosis program in all its patient treatment and management policy matters.
  2. It shall facilitate and support community action to build capacity of individuals and communities for maintaining and sustaining services that are essential for TB control.
  3. It shall build on its strength, its skills and experience in health related areas. And through community involvement.
  4. It shall utilize DOTS as a main treatment strategy.
  5. It shall integrate DOTS with other health and community related services.

Our Methodology

It shall focus its treatment and management on the principles of DOTS.

  1. Diagnosing TB patient primarily through sputum microscopy with additional support from chest X-Rays and clinical evaluation by the physician.
  2. Its treatment shall consist of following a continuous and uninterruptive supply of high quality TB medicines.

Advocacy

It shall advocate and draw attention of policy makers, donors and the media to the magnitude of the TB epidemic and to the benefits of affective TB control. Assistance and collaboration with various other organizations advocating on behalf of groups in society, who are disadvantaged shall also be made. Organizations of events and occasions to advocate on behalf of, and with the patients, and the programs for raising awareness and increase commitment to DOTS. The main focus of these activities to get the message STOP TB across to politicians, leader and the media, to encourage them to take TB epidemic seriously.
It shall involve private sectors in TB control efforts and to involve the private practitioners by collaboration and establishing links with them and by encouraging them to refer patients for DOTS or for providing diagnostic and treatment services to the private practitioners, in addition links with branches of medical associations, chest phycians, para medical workers, pharmacists and other associations will be made. By development of network of private practitioners, thereby acting as an interface between the private and the public sectors.

Research

It shall conduct research by following a standardized national policy and research programs protocols on scientific lines shall also be carried out, this shall include the recording of data and documentation of the results of treatment (DOTS) and the exchange of such material between various TB care organizations both at national and international level, thereby acting as a interface between the private providers and the NTP.

It shall function in collaboration and coordination with the national TB control program, the anti TB association and shall follow the treatment guidelines of the WHO and IUALD. It shall exchange information and carryout research both with the national and international TB care organizations.

Community Education

Education and awareness of the community about tuberculosis through health education dissemination and publication of information and communication shall also be fully utilized along with the provision of DOTS going hand and in hand with an education program.

Dissemination  Of  Information

It shall publicize information through newsletters, journals, websites and other means of communication shall be utilized for the purpose of creating awareness, exchange and dissemination of information on tuberculosis both for the general public and the medical community.

Utilization of the mass media (TV & Radio), printed materials (posters & pamphlets) and drama (puppet shoes, street theaters) and by the word of mouth through the health workers. The purpose being to bring about an awareness and knowledge of the public in general and the decision makers, the importance of the treatment, prevention and the control of tuberculosis.

Volunteer Support

It shall seek support for controlling TB through provision of care as close as possible to the patient’s home accordingly community volunteers, local leaders, civil service organizations, colleague in workplace, religious leaders, shop keepers, teachers, and many others will be actively and usefully involved in helping cure TB. Relatives and neighbors shall also be used as a means of facilitating and providing support to care givers, in addition where necessary outreach workers and volunteers shall take part and provide social support, observation of treatment, nursing care and education.