Afghanistan: Doctors struggle to contain TB

In sharp contrast to the global trend, women in Afghanistan tend to suffer from tuberculosis, or TB, at a much higher rate than men. Doctors in Afghanistan, with the help of UN experts, are trying to better understand the sources of infection. They are also striving to develop new methods to contain the spread of the disease amid Afghanistan's ongoing Islamic radical insurgency.

"In other parts of the world, TB is a disease of young men, and here [in Afghanistan] we see that 70 percent of the cases are female - a fact that has yet to be satisfactorily explained," said Dr. Sara Morgan of the NGO Medair.

TB thrives amid conditions of poverty and malnutrition. There are plenty of both in Afghanistan, and women tend to occupy the lowest rungs on the social ladder. Many don't get enough to eat.

"We know, for instance, that women are segregated in the house, have several and frequent deliveries (i.e. births), are often undernourished and live in close quarters. All of these can be factors as to why women are more prone," noted Giampaolo Mezzabotta, a TB medical officer for the World Health Organization (WHO). "This is worth studying further and we are going to do that."

For Afghan women with TB, getting treatment can be an ordeal. Those living in rural areas often need to travel long distances with a male relative to reach the nearest medical facility. This can exert tremendous economic stress on an impoverished family that is dependent on the income of the accompanying male. Given the economic implications and social restrictions, women tend to be diagnosed for TB later than men, and the later the diagnosis, the harder the disease often is to treat.

According to WHO estimates, each person with active TB, if left untreated, is capable of infecting on average between 10 and 15 people every year. To contain TB, the UN and WHO have partnered with local Afghan entities to create the Stop TB Partnership. The nationwide program emphasizes prevention, and also explains how people with the disease can receive treatment.

In Kabul, those with TB symptoms are instructed to visit a clinic in the Darlaman section the capital. There, some poorer Afghans who test positive for TB are offered food as an incentive to keep returning to the clinic for daily treatment. For women with advanced cases of TB, the Afghan Ministry of Public Health has established an in-patient facility.


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