High rates of TB in Pacific highlighted by Guam conference
Updated
People in the US territory of Guam are 12 times more likely to get tuberculosis (TB) than their counterparts on the American mainland. The issue has been discussed at the 7th Annual US Pacific Island Tuberculosis Conference in Guam. Those attending have also discussed the fact that the majority of TB cases are reported in indigenous Chamorro people or in Filipino immigrants.
Presenter: Kate McPherson
Speaker: Cecile Arciaga , Guam's TB control manager
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ARCIAGA: Tuberculosis is global. It can happen to anybody. Although of course the burden is much higher here in the Pacific Island jurisdiction and just for Guam alone, our rates are actually six times more of Hawaii and 12 times more of the United States as a whole. The same thing also with the rest of the Pacific Island jurisdiction. Except of course for American Samoa, most of our rates are still high compared to the US mainland. We do have our share also of those cases coming from the other Micronesian countries. A lot of our cases are coming from FSM because of the proximity to Guam and we are seeing actually a rise of our cases amongst this group.
MCPHERSON: And why is this?
ARCIAGA: Well, right now, of course, infrastructure is one. Availability of medications for some will be quite a problem, and especially in the Pacific Island jurisdictions, demographics, the hard to reach clients . . . and one of the major medical conditions that we are actually even discussing right now is the incidence of diabetes. You know if you have a positive skin test [for TB] and you are a diabetic, the risk for you developing active TB is actually three times more. As we all know, the incidence of diabetes, not just in Guam, also in the Pacific Island jurisdictions is quite high. When your immune system gives up on you, or you have other medical conditions, that will increase the risk of these germs becoming active and causing disease.
MCPHERSON: And is that why those statistics are higher on Guam, because some peoples immune systems are much lower than say on the mainland?
ARCIAGA: Yes, exactly. It is spread whenever a person with active pulmonary or laryngeal TB coughs, especially if they are left undiagnosed and are symptomatic, because it is airborne. Technically people around them could easily catch it. But of course even if you are exposed to someone with active TB, it does not necessarily mean you are going to develop the active form of TB. These TB germs can actually stay dormant or may stay dormant in your body and only when your immune system gives up on you, that's when it suddenly becomes active.
MCPHERSON: So can we talk about prevention then? What have you been discussing at this conference about prevention?
ARCIAGA: I think the number one thing is that we need to find active cases. Once you find the active cases, you have to treat these active cases, because if you don't find these cases and you don't treat them, there is a cycle. It is an endless cycle of infection and infection and reactivation which normally would happen when a case out there is left undiagnosed. So the number one prevention that we normally would do is educate the community on how TB is transmitted.
MCPHERSON: And so that's part of the control method as well then, is it? Community knowledge?
ARCIAGA: Community awareness. Increase the awareness of the community on Tuberculosis. What are the signs and symptoms of TB? Now once the community is aware of what is the sign and symptoms of TB, which are of course prolonged cough of more than two weeks, loss of appetite, fever, unexplained weight loss. We also need to educate the medical community.
MCPHERSON: Drug-resistant TB has been an issue that we have covered recently as well. What specifically have you discussed about this and what can be done?
ARCIAGA: The thing is the drugs are more expensive. They're very toxic and sometimes not even that effective. If we have a drug-resistant TB, we normally would, as a state or as a country, have to make sure that we have a buffer of supplies for this medication to ensure that the patients are being treated properly.
