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TB epidemic twice as deadly as dengue

TB epidemic twice as deadly as dengue

DURING July 1995, Kantha Bopha hospital made 36,409 consultations of sick

children and hospitalized 1,927 very sick children.

Seven hundred and

seventy seven children had dengue. Most of them travelled from afar, often in

desperate states, suffering from shock which is more difficult to treat the

longer it has been pre-existing.

This is why the dengue mortality rate is

so high: more than three percent. Without our laboratory and bloodbank, we would

lose many more children. Sometimes more than 30 transfusions are done each day.

Two big rooms have been temporarily set up as long as this dengue epidemic

continues. Instead of beds, we use mattresses on the floor so as not to waste

space.

Two hundred and fourteen children of those admitted had

tuberculosis (TB) - this is unique in the world. Their mortality rate last month

was twice as much as those with dengue (seven percent). Dengue epidemics are

expected every three to five years; the TB epidmic is permanent, and it is far

more difficult to diagnose in children than is dengue.

Kantha Bopha is

the only place in Cambodia with the skilled staff and facilities to diagnose TB.

That is why we are worried that the real figures for TB are much higher than can

be guessed.

TB children often arrive with different diseases at the same

time (dysentry, malaria, thyphus). They suffer from from TB-meningitis,

TB-osteitis (affecting the bones) and of the lungs and

intestine.

Sixty-five percent of all children suffering from bacterial

infections of the respiratory tract have TB; 70 percent of those with

malnutrition symptoms have TB.

We think that the recommendations of

international health organizations how to manage child health have to be

immediately changed, improved and corrected. The protocol on how to manage

infections of the respiratory tract does not even mention TB. The same goes with

the protocols of how to handle diarrhea and malnutrition.

There is no

effective prevention for TB. The vaccination is not good enough, one never knows

for how long it will remain active. Even children suffering from the most severe

TB are being vaccinated.

All sick and infected people must be treated to

stop this contagious epidemic from spreading even further.

As soon as

hospitalized children are stabilized they are sent home.

Follow up is

done in the following nine months in our new, small TB

center.

Ninety-five percent of families keep their appointments. They

follow the treatments and controls because they have been informed about TB, and

they get free medication from the center - even the poorest families keep their

appointments and observe the follow up treatments.

The drug treatment we

use, Rifater, is the same used in Switzerland and the United States. Treatment

for all children of the world should be the best possible.

Beat Richner, director fo the Kantha Bopha Children's Hospitals

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