This action plan is the key knowledge for a briefing paper for the prevention of highly pandemic disease tuberculosis in Pakistan. The main purpose of this action plan to build more effective policies and strong strategies to stop the transmission of the tuberculosis and to eliminate this from Pakistan. Tuberculosis is an infectious disease caused by mycobacteria, usually mycobacterium tuberculosis, it spreads through air and transmission of respiratory fluid of the people with active tuberculosis infection (kumar et al, 2007). A study suggests that approximately 1/3 of the world’s population has tuberculosis infections (Tuberculosis fact sheet, 2010) and every year 1% of the world’s whole population gets tuberculosis infected (WHO, 2002) According to an estimate about 13.7 million chronic cases found in 2007 (WHO, 2009). Another study stats that 8.8 million new cases diagnosed with tuberculosis and 1.45 million among them leads to death every year in developing countries (WHO, 2011). Another study illustrates that tuberculosis is second most common cause of deaths after the HIV/AIDS (Dolin et al, 2010).
However there was a significant reductions in prevalence and incidence being seen since 2005 and 2002 respectively (WHO, 2011) It has been observed that tuberculosis is distributed all over the world but 81% Asian and Africans countries are infected with tuberculosis where 5 to 10% diagnosed in united states. In Pakistan Tuberculosis is one of the leading cause of serious sickness which results in high mortality rate approximately 240,000 people get sick which causes approximately 70,000 deaths every year (Khan and Malik, 2003). Tuberculosis place Pakistan at number 6th in highly affected states (Vermund, 2009 ). According to WHO a progress has been made after launching National Tuberculosis Control program in Pakistan since it is established 1.5 million treated free of cost. Key Competencies
Tuberculosis is highly concerning issue in Pakistan and it is highly contagious disease will associate to the key competency area six in faculty of public health which aims to protect the general public from communicable diseases and hazards. Theme
The fundamental theme of this paper is to eliminate the tuberculosis from Pakistan. Tuberculosis comprises 5.1% of total disease burden of Pakistan. Over the decade lot of work been done in this area but despite all that still significant number of issues related to TB are present and express that this disease have strong link with the socio economic status of people (Link and Phelan 1995), 75% patient were at reproductive age group, many of them consulted to untrained practitioner in an informal setup which leads to severity of disease (Khan, 2001). In 2000 directly observed therapy short course DOTS strategy was adopted in National TB control strategy and further expanded at primary health care units, this program was successful and achieved 70% diagnosis of cases and 85% outcome of the global target which set by Stop TB Partnership (Khan, 2001). Still a lot more to dig in this area to eradicate the tuberculosis, need to build strong awareness in general public and community partnership and involvement should be encouraged. Points to Emphasise:
What is this disease?
What are the the causes?
What are the risk factors?
Who is at risk?
What is the current situation of disese in Pakistan and
How to prevent it?
Many efforts have been made to eliminate the tuberculosis from the world, several countries made number of polices for the elimination of tuberculosis in their stats. The global TB control program aims for prevention, care and control. Introduced guidelines to for the global response to threats and to promote the immunisations (Global Tb programme, 2010). WHO introduced the six key points to Stop TB strategy which builds on success of the DOTS and also addressing the key challenges facing. It aims to reduce the global TB burden by 2015 (Raviglione and Uplekar, 2006) In Pakistan with collaboration of Stop Tb partnership and Eastern Mediterian regional office with consultation of national TB control program together they develop the frame work and functions to eliminate the TB in Pakistan (Stop TB, 2006). In Pakistan DOTS strategy was also applied after the declaration of emergency in 1995 however in first three year the program was unsuccessful due to lack understanding in federal and provincial units and shortage of regular funds however in 1998 the policy was reviewed and reconsidered for tb control in Pakistan (Stop TB, 2006). New Initiatives
Need to develop strong consensus in between federal and provincial units for the elimination tuberculosis. A consistent and detail policy should be regulated to eradicate the TB Strengthen the people by providing them knowledge of the disease and raising the awareness for the risk factors and causes of the tuberculosis. Focusing the public gatherings like in masjids, schools and workshops should be arranged to increases the knowledge about the transmission and spreads of disease. Tribal areas should also be focused because they usually neglect such campaigns on religious basis (Teepu, 2012) Campaigns should be made for fund raising and to motivate the people against tuberculosis. Strategies
Main objectives of strategies should be working specifically for the elimination of tuberculosis to make Pakistan a TB free state. WHO developed very detailed and strong strategy fight against TB effectively, this is based on six key points High quality expansion of DOTS strategy
Address the TB, HIV MDR and provision of requisite of people at risk Delivering the best at primary health care level.
Taking all health care workers, researcher and practitioner at same board Advocate and empower the community for fighting against tuberculosis To ensure and support the promotion of research in this area. Impacts
Implementation of these polices and strategies will give us the desired results in order to eliminate the tuberculosis from Pakistan, In India and Pakistan mass vaccination program was started in 1948 as it was first countries outside the Europe who started immunization (Mahler and Ali, 1955). Immunization would help to eliminate the tuberculosis by ensuring the provision of BCG Vaccine to every new born or child (WHO, 2004). It will help to remain protected from disease throughout the life, reduces the rate of disabilities and immunization is cost effective than to treat the disease. Conclusion
In the light of evidence the tuberculosis is highly contagious epidemic disease and requires immediate attentions. The government of Pakistan should take necessary steps to reduce the prevalence of tuberculosis from the state.
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