Majority of TB cases among expats

Expatriates, who are diagnosed with tuberculosis (TB), have to be sent back home as per the UAE law, but once cured these TB patients can return to the UAE provided they produce a certificate from their country that they are TB free, said Dr Ajit K. Nagpal, Adviser, Hospital Affairs, UAE Ministry of Health.

Dr Nagpal told Khaleej Times that out of between 300 to 400 new TB cases discovered each year in the UAE, more than three quarters, or 78 per cent, are expatriates. He said that the UAE will mark World TB Day this year on March 23.

"Because TB is not so prevelant or widespread in the UAE, setting up isolation hospitals or sanitoriums for TB patients is not a priority. In fact, the prevelance rate of TB in the UAE is 12.5 cases for every 100,000 population, which is better than the world average," Dr Nagpal said.

He pointed out, however, that some TB cases become drug resistant and remain sputum positive and infectious, which means they need to remain isolated from the rest of the population and treated with stronger drugs.

Dr Nagpal said the reason some TB cases do become drug-resistant is because some patients neglect to complete a course of treatment. He said the way to test a person who is still infected is to test sputum regularly.

"TB is now treated at home. With modern treatment a patient is ambulatory and free to mingle in the community. A patient is isolated only when he or she is infected. There are only a few cases that are resistant to TB drug treatment and remain infected. Few TB patients these days have badly damaged lungs to warrant surgery," Dr Nagpal said.

The expert stressed that TB is "a disease of public health hazard" and is categorised in the UAE along with HIV Aids and Leprosy. Expatriate residents are sent to their home country if they are found suffering from this disease.

A National Tuberculosis Control Plan has been developed in the UAE in response to the World Health Organisation (WHO) initiative on TB. Population structure and dynamics, epidemiology of the disease and the health care delivery system in the country have all been taken into consideration. The long-term objective of the plan is to reduce incidence of TB in the UAE to less than one case per 100,000 population by the year 2010.

The plan's short-term goals include reducing prevelance of TB to three for every 100,000 population by the year 2005. The implementation of the plan includes the formation of a national committee for TB control, establishing competent recording and reporting systems, and strengthening the screening for new expatriates coming into the country.a