SANAA, 27 March 2007 (IRIN) - SANAA, 27 March 2007 (IRIN) - Although Yemen has the second highest tuberculosis (TB) mortality rate in the Middle East, after Iraq, specialists say the disease is on the decline because of a concerted awareness campaign and training programmes for health workers.

"The problem is not as big as it used to be several years ago," Amin Noman al-Absi, General Director of the National Tuberculosis Control Programme (NTBCP) at the Ministry of Heath, told IRIN. "Yemen adopted Direct Observer Therapy Short-course [DOTS] in 1995, and now it covers 90 percent of Yemen's 333 districts."

DOTS is an international protocol for controlling infectious diseases, most commonly TB. Lying at the heart of the World Health Organization's (WHO) 'Stop TB Strategy', it involves boosting political and financial commitments to fighting TB, and ensuring better case detection, treatment, drug supply, and monitoring of the disease.

According to al-Absi, the rate of cured cases via Yemen's DOTS programme is 86 percent.

A number of health workers have been trained on TB treatment throughout the country. "Now training will target midwives and nurses. They will be trained on how to identify TB levels among patients and how to handle TB medications," he said.

The health official added that there is a new initiative in Yemen to make the private sector, military hospitals, central prisons and NGOs participate in the treatment of TB.

Fourth biggest cause of death

TB is the world's greatest infectious killer of women of reproductive age and the leading cause of death among people with HIV/AIDS. In Yemen, the disease is the fourth biggest cause of death.

According to WHO, nearly two billion people - one third of the world's population - have tuberculosis. Annually, eight million people become ill with tuberculosis and two million people die from the disease worldwide.

The annual incidence rate varies from 356 per 100,000 in Africa to 41 per 100,000 in the Americas. In Yemen, the annual incidence rate of TB has dropped from 236 per 100,000 in 1990 to 82 per 100,000 in 2005, according to WHO statistics.

In the same period, Yemen's TB mortality rate has dropped from 16 per 100,000 to 10 per 100,000. This compares to a TB mortality rate of 50-100 per 100,000 in many African countries and a typical rate of 1 per 100,000 in Western European countries.

On 10 February this year, Yemen's TB control programme embarked on a new survey to determine the exact nature of the problem in the country. The survey, supported by the Global Fund for Combating AIDS, Malaria, and TB, is targeting students aged 7 to 12 in 132 schools.

In addition, NTBCP has awareness programmes for TB patients on seven local radio stations and on television.

"We distribute posters among patients and educate them on how to prevent the epidemic. We have also trained volunteers from other NGOs who are interested in raising awareness of the dangers of TB and ways of preventing it," Othman al-Hasoosah, Head of Activities Department at the NTBCP, said.

Al-Hasoosah said that poor hygiene and poverty were the two main factors responsible for traditionally high incidence of TB in Yemen.

"Some patients don't follow the prevention instructions given to them as they don't use tissues or handkerchiefs when they cough or blow their noses," he said. "Poverty also plays a big role in the spread of TB among people, especially in rural areas. Family members gather in one cramped room, chewing qat [a mild narcotic] and smoking cigarettes or water pipes."

maj/ar/ed

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