One of the world’s most prevalent diseases is tuberculosis and is caused by a bacterium named Mycobacterium Tuberculosis. A short form for the word “tuberculosis” would be TB. There are different types of symptoms when one gets infected with TB, one such symptom would be chest pain or nausea. TB is usually found in the lungs (Gissy 2006). Like many other diseases, it is quite contagious. But not as bad as the Black Death, a plague in mid 14th century, (Metcalf 1991) which killed XX amount of people. The actual origins of human contracting this disease is still unknown, however, there are scientists who believed that cattle are the original source of tuberculosis infections.
Some also believe that Mycobacterium tuberculosis was actually evolved from Mycobacterium bovis (Metcalf 1991). With little evidence, people neglected the theories that were made by the scientists until Robert Koch discovered this disease in 1882 (Pan 1996). In order to get infected with TB, one must be in the same room with a person infected. Tubercle Bacillus is an air borne disease, which means someone infected can pass on the disease to a healthy person through sneezing or coughing. In order to quarantine the disease, nations developed tuberculosis control programs (Lee and Buch 1991). The purpose of this research is to compare the control of tuberculosis in a developing country, South Africa, and a developed country, Australia.
The World Health Organization declared tuberculosis as ‘a global emergency’ in 1993 when the disease had spread and infected more than a third of the world’s population (National Health and Medical Research Council 1994).
2.1Mobility and Mortality
Detection rates in both Australia and South Africa has been increasing, however, the treatment success rates in South Africa still remain low. According to the WHO (2008), the DOTS treatment success rate only increased by 2% (69% in 1996 to 71% in 2006) resulting in 218 deaths per 100 000. Compare to Australia, with a mortality rate of 0.6 deaths per 100 000.
2.2Tuberculosis in Specific Ethnic Groups
The effect of tuberculosis on Australian Aboriginals is much greater than the other ethnic groups due to a low socioeconomic standard (National Health and Medical Research Council 1989). In many developing countries like South Africa, diseases such as the Human Immunodeficiency Viruses are a threat because it is easily associated with tuberculosis. With HIV in their blood stream, one may get a positive infection of TB (WHO 2008).
2.3Different Significance of Tuberculosis
There are two consequences of tuberculosis, when one gets infected with the disease. Either, there is a 10% chance that it will gain activeness (National Health and Medical Research Council 1994). In other cases, tuberculosis may not generate at all, leaving them immune.
With new technologies provided to improve treatment, the detection rate of TB will have a huge improvement, as well. With good treatment, 90 – 93% of the infected have the chance of success; 5-7% of them would die and 2-3% would remain in the state they’re in (Strebel and Seager 1991).
Annually, there are new cases of tuberculosis infecting people and this is causing a huge problem. In 2005, WHO declared tuberculosis an emergency in Africa. The annual amount of new tuberculosis cases caused about 540 000 deaths. This started the “tuberculosis global response plan” presented by the WHO in 2007 (WHO 2007).
3.1Stop Tuberculosis Strategy
The official goal, to minimize the cases of tuberculosis by the year 2015, is a collaboration of Stop TB Working Groups and Secretariat (WHO 2007). 49 000 lives were saved in 2007 and the amount save in 2008 was about twice that figure. In there were about twice the amount more saved in 2008, in order to achieve a better goal, it was set to 1.2 million lives by 2015 (WHO2007).
3.2Global Tuberculosis Epidemic and Progress
According to Stop TB Partnership (2006), there are currently 15 diagnostics, 27 drugs and 12 vaccines treatment in the tuberculosis research. Unfortunately, the number of new cases has not decreased. In the year 2006 alone, there were 9.2 million new cases. Of those 9.2 million, 1.7 million deaths were from TB, 0.7 million cases and 0.2 million deaths were from people infected with HIV (WHO 2008). In order to get a positive result on the future outcome of tuberculosis, the STOP TB Partnership has separated the goals and targets to 3 specific years (WHO 2006). By 2005, 70% of the people with positive TB will be diagnosed and 85% of them will be cured. By 2015, tuberculosis in highly infected countries is aimed to be reduced by 50%. By 2050, there will be less than 1 case per 100 000 000 persons per year (WHO 2008).
Directly Observed Treatment Short (DOTS) courses and the programs manage the diagnosis and treatment of infectious cases. In 1997, the WHO’s Director-General, Dr. Hiroshi Nakajima stated DOTS strategy for TB will be important, as lives will be saved (Shri 2001). Comparing prevalence, mortality and incidence as a progression towards the mission, tuberculosis rates have become better and yet worst. According to the WHO report (2008), the number of new cases within the population has decrease, therefore the deaths per 100 000 have decreased. This means the treatment was successful. However, the incidence level has risen from 1990 to present (WHO 2008).
New drugs are being created for the benefit of those infected with tuberculosis. Such drugs include; the Multidrug-resistant TB (MDR-TB) and extensively drug resistant TB (XDR-TB) (WHO 2006). However, the costs of these drugs are relatively high and for those who live in low-income countries such as South Africa it are in accessible. 45 countries need about US$2.15 billion in order to make the drug efficient enough to eliminate tuberculosis (WHO 2007).
Tuberculosis control is aimed to minimize the amount of tuberculosis cases in all countries, especially the high-burden countries. In order to reduce infection and further spreading, organizations aim to improve the socio-economic standing and to upgrade health services with better control programs (Lee and Buch 1991).
4.1Tuberculosis Control in Australia
In general, Australia has a fairly low rate of tuberculosis cases but if the country was broken down into subgroups, the Indigenous people and those who were born overseas have higher number of cases than those who are non-Indigenous Australian-born (National Threat Assessment Centre 2002). During the 1950s, when tuberculosis was first discovered, it was recognized as a major cause of death and ill health in the Australian community. Since then, scientists have introduced an effective chemotherapy that greatly reduced the TB rates in Australia since 1970 (National Health and Medical Research Council 1989).
The treatment success in Australia has been gradually getting better due to better healthcare and improved drugs. In 1997, there was a 66% success rate and this has increased to an 80% success rate. Comparing the statistics of 1998 to 2006, there’s change of 2.3 to 5.1 new notifications per 100 000 population (WHO 2008). Based on the National Threat Assessment Centre (2002), Australia’s tuberculosis control program aim to lower TB rates and prevent further transmission by improving early detection methods and treatment (National Threat Assessment Centre 2002).
4.2Tuberculosis in South Africa
There are 22 countries in the world responsible for 80% of the tuberculosis burden – 9 of them are in the African Region. Africa is one of the 3 regions with the worst epidemiological results where tuberculosis incidence is still raising even though death rates have decreased (WHO 2006). Africa was known as virgin soil for tuberculosis because there was no sign of TB in Africa during the 18th century and early 19th century. However, during the latter half of the 19th century, tuberculosis was found among Africans especially those who were fairly close with the Europeans (Packard 1989).
Before the WHO declared Africa in a tuberculosis emergency, DOTS did not pay attention South Africa in 1996 but once the emergency was declared, their coverage span jumped to 100% almost 10 years later. In 2006 alone, one third of the tuberculosis infected patients were HIV positive bringing this country to become ranked 4th among the African Regions (WHO 2008). Healthcare now easily accessible to the people in Africa due to DOTS’s achievement in to training the healthcare workers on TB infection control so that it can help accelerate the reduction of mobility and mortality related to TB by 2015 while successfully detecting and curing any many patients. (WHO 2006).
The comparison between South Africa and Australia shows the contributions towards tuberculosis that has been made. South Africa has a lower mortality rate because the healthcare availability is limited and poverty is a problem. Australia, on the other hand, has a high mortality rate but certain subgroups need to be paid special care. South Africa is rank 4th among the African region for tuberculosis in children, young adults and elders. Australia has differences in sex and age as the males tend to get infected more than the females by 40%. While only teenagers, young adults and elders have a higher chance of getting infected with tuberculosis (WHO 2008). The cost of treatment in South Africa is expensive for those living there so DOTS has made proposals to reduce the fee (Siringi 2003).
On top of that, health workers are being trained about the consequences of tuberculosis and they will help increase community awareness around World TB Day (WHO 2008). Australia is going to limit the transmission of the disease by detecting early cases so as to quarantine the disease in one place. Incidence rates among Indigenous people are 8 times higher than the non-Indigenous people. Australia has an efficient healthcare system which is bringing better results to the control of tuberculosis, as seen through the treatment’s high success rate (80%). Compared to Africa’s healthcare system, Australia is far better because South Africa is a high-burden country. South Africa only has a 71% success treatment (WHO 2008).
The control of tuberculosis is to prevent more people from getting infected with the disease. With the help of better treating facilities and programmes, Australia and South Africa are aiming for a better ways to control tuberculosis and have set targets and goals to reach a better result. Australia is focusing on the Indigenous people and the non-Australian born people in order to eliminate the disease. South Africa is aiming to limit the problems of HIV and TB, since a positive HIV infected person can also easily be infected with TB, by focusing on better and cheaper healthcare.