Prevalence of Tuberculosis in Tehsil Matta Swat Khyber Pakhtunkhwa

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EUROPEAN ACADEMIC RESEARCH Vol. II, Issue 1/ April 2014 ISSN 2286-4822 www.euacademic.org Impact Factor: 3.1 (UIF) DRJI Value: 5.9 (B+) Prevalence of Tuberculosis in Tehsil Matta Swat Khyber NAVEED AKHTAR SHAHROZ KHAN KAUSAR SAEED JEHANGIR KHAN BAKHT TAREEN KHAN ZAHEER AHMAD Department of Zoology Abdul Wali Khan University Mardan (Buner Campus) Pakistan Abstract: Tuberculosis is the leading cause of mortality worldwide. The current study was designed to evaluate the proportion of tuberculosis in Tehsil Matta. Total numbers of 378 patients were investigated in the period of September to December 2013. The disease burden was recorded high in females that was 213 (56.34%), than males 165 (43.65%). The high collection was done in the month of September (28.59%). It was concluded that tuberculosis was prevalent in the area. Key words: Tuberculosis, Prevalence, Disease burden, Matta, Swat. Introduction TB is a major health problem worldwide with mortality ranging from 1.6 to 2.2 million lives annually. The situation had become worst due to increase in the incidence of drug resistant tuberculosis (Aftab et al. 2009). Tuberculosis remains a main health problem affecting about a third of the world population in spite of a number of preventive and control measures taken in the past few decades. It is accountable for an approximately 8.8 million cases and 1.4 154

million deaths worldwide (WHO 2009; Hargreaves et al. 2010). According to survey it is expected that Africa contributes about 29% and 34% of all tuberculosis related morbidity and mortality to the worldwide load. In Ghana, tuberculosis remains a main reason of preventable adult morbidity and mortality (Ahorlu et al. 2013). More than any other single infectious agent it is believed that tuberculosis is responsible for more adults deaths each year (WHO 2009). Tuberculosis occurs at any stage of life, to any age group and can affect almost all organs of the body (Fanning 1999). Tuberculosis being one of the world s leading infectious diseases had caused 8.7 million incident cases and 1.4 million deaths in 2010 approximately (WHO 2012). The major health problem and an important unnecessary risk for premature death is the use of tobacco. Relations between tobacco smoking and TB had been shown in wide research (Bates et al. 2007; Lin et al. 2007; Slama et al. 2007; Van Zyl Smit et al. 2010), and increased rate of death has been identified among smokers due to tuberculosis (Reed et al. 2013). The problem of tuberculosis had become further complicated by the rapid spread of human immunodeficiency virus (HIV) and the appearance of drug resistance. HIV play key role in increasing the incidence of tuberculosis as it makes the diagnosis of tuberculosis difficult (Narain et al. 1992; Raviglione et al. 1992). Pakistan ranks sixth among countries with a high burden of tuberculosis. In Pakistan tuberculosis is prevalent in 420,000 and incidence is 231 per 100,000 population (WHO 2010) Pakistan is among the 27 countries with high burden of MDR TB (WHO 2010). According to a 2008 there were approximately 15000 MDR TB patients in Pakistan (WHO 2010). To the best of our knowledge not many studies have 155

been conducted on assessing public awareness of tuberculosis in population setting in Pakistan (Mushtaq et al. 2011). Current study was carried out to evaluate the epidemiology, sex wise distribution and burden of disease in Tehsil Matta District Swat, Khyber Pakistan, Methods and Materials A descriptive study was conducted in the period of April to December 2013. Total 378 of patients were investigated in the study period. Data was collected through proforma containing the whole information about the patients, i.e gender, age, address, previous treatment and current treatment. The analysis of data was done age wise, sex wise and month wise. Results and Discussion Total 378 patients were investigated out of which 213 (56.34%) were females and 165 (43.65%) were males. The highest infection rate was found in the age of 31-40 years that was 173 (45.46%). According to (Ayaz et al. 2012) the infection rate of TB was high in age of 10-20 years that was (68.96%), (35.29%) infection was recorded in age from 21-40 years and the lowest infection rate was recorded in more than 40 years of age that was (15.06%). Similarly (Ahmad et al. 2013) reported the maximum numbers of patients in age of 15-64 that was 82.72. In our study the highest infection rate was found in the age of 31-40 years that was 173 (45.46%). The details are shown in table 1.1. Age Frequency Percentage 1-10 years 22 5.82 % 11-20 years 41 10.84 % 21-30 years 54 14.28 % 31-40 years 173 45.46 % 41-50 years 61 16.13 % 156

51-60 years 27 7.14 % Table 1.1: Age wise distribution of patients (n= 378) According to (Ayaz et al. 2012) high incidence of tuberculosis was recorded in female that was (16/78) 33.33 % than male that was (23/75) 30.66%. According to (Ahmad et al. 2013) ratio of tuberculosis was higher in female as that of male population and the recorded ratio of amount was (60/110) 54.55% and (50/110) 45.45% respectively. According to (Ullah et al. 2008) the numbers of male patients were 176 and female patients were 349. According to (Akhtar et al. 2014) the ratio of male was 137(44.19%) and female was 173 (55.80%). In our study it was found that infection was high in females than males. The details are shown in table 1.2. Age Male Female 1-10 years 10 12 11-20 years 16 24 21-30 years 24 30 31-40 years 77 96 41-50 years 27 34 51-60 years 11 17 Total 165 213 Table 1.2: Sex wise distribution of patients (n=378) A high prevalence 17(37.77%) was recorded in the month of July, followed by May 18 (34.61%) and June 14 (25%) of 2010 (Ayaz et al. 2012). In our study the high infection was recorded in the month of September (28.59%), followed by October (24.72%), November (23.45%) and lowest infection was found in month of December (23%). Month wise distribution of tuberculosis is shown in figure 1.3. 157

Figure 1.3: Month wise distribution of Tuberculosis Conclusion This survey shows that the people are unaware about tuberculosis in many aspects i.e. symptoms, diagnosis, treatment and transmission. Government has to educate people through media, seminars etc. The TB awareness programs should be initiated in order to aware the people about its signs and symptoms, transmission, treatment etc. BIBLIOGRAPHY: Aftab, R., F. Amjad, and R. Khurshid. 2009. Detection of mycobacterium tuberculosis in clinical samples by smear and culture. Pak. j. Physio. 5: 27-30. Ahmad, T., S. Ahmad, Haroon, M. Zada, A. Khan, S. Salman, N. Khan, and F. Gul. 2013. Epidemiological Study of Tuberculosis. European Academic Research 1(8). Ahorlu, C. K., and F. Bonsu. 2013. Factors affecting TB case detection and treatment in the Sissala East District, Ghana. Journal of Tuberculosis Research 1(3): 29-36. Akhtar, N., Khan, B. T, Saeed, K., Khan, S., Khan, J., and Ahmad, Z. 2014. Prevelance of Tuberculosis: Current status in Manglawar District Swat, Khyber, Pakistan. European Academic Research. 1(12): 5160-5166. 158

Ayaz, S., T. Nosheen, S. Khan, S. N. Khan, L. Rubab and M. Akhtar. 2012. Pulmonary Tuberculosis: Still Prevalent In Human in Peshawar, Khyber,Pakistan. Pak. j. life soc. Sci 10(1): 39-41. Bates, M. N., A. Khalakdina, M. Pai, L. Chnag, F. Lessa and K. R. Smith. 2007. Risk of tuberculosis from exposure to tobacco smoke: a systematic review and meta-analysis. Arch Intern Med 167: 335-42. Fanning, A. 1999. Tuberculosis: 6. Extrapulmonary disease. CMAJ 160: 1597 603. Hargreaves, J. R., D. Boccia, C. A. Evans, M. Adato, M. Petticrew, and D. H. Porter. 2010. The social determinants of Tuberculosis: From evidence to action. American Journal of Public Health 101: 654-662. Lin, H. H., M. Ezzati and M. Murray. 2007. Tobacco smoke, indoor air pollution and tuberculosis: a systematic review and meta-analysis. PLoS Med 4:e20. Mushtaq, M. U., U. Shahid, H. M. Abdullah, A. Saeed, F. Omer, M. A. Shad, A. M. Siddiqui, J. Akram. 2011. Urbanrural inequities in knowledge, attitudes and practices regarding tuberculosis in two districts of Pakistan's Punjab province. Int J Equity Health 10: 8. Narain, J. P., M. C. Raviglione and A. Kochi. 1992. HIV associated tuberculosis in developing countries: epidemiology and strategies for prevention. Tuberc Lung Dis 73: 311-21. Raviglione, M. C., J. P. Narain and A. Kochi. 1992. HIVassociated tuberculosis in developing countries: Clinical diagnosis and treatment. World Health Organ 70: 515-26, 1992. Reed, G. W., C. Hongjo, L. So Young, L. Myungsum, K. Youngran, P. Hye mi, L. Jongseok, Z. Xin, K. Hyeyngseok, H. SooHee, C. Metthew, C. Ying, C. Sang- Nae, B. Clifton, V. Laura and K. Hardy. 2013. Impact 159

of diabetes and smoking on mortality in tuberculosis. PLoS One 8:e58044. Slama, K., C. Y. Chiang, D. A. Enarson, K. Hassmiller, A. Fanning, P. Gupta and C. Ray. 2007. Tobacco and tuberculosis: a qualitative systematic review and metaanalysis. Int J Tuberc Lung Dis 11:1049e61. Ullah, S., S. H. Shah, A. Rehman, A. Kamal, N. Begum, and G. Khan. 2008. Extrapulmonary tuberculosis in lady reading hospital peshawar, NWFP, Pakistan: survey of biopsy results. J Ayub Med Coll Abbottabad 20(2). Van Zyl Smit, R. N., M. Pai, W. W. Yew, C. C. Leung, A. Zumla, E. D. Bateman, K. Dheda. 2010. Global lung health: the colliding epidemics of tuberculosis, tobacco smoking, HIV and COPD. Eur Respir J 35:27e33. WHO. 2009. World Health Organisation: Global tuberculosis control: surveillance, planning, financing. Geneva. World Health Organization. 2011. WHO report. Global TB control. WHO/ HTM/TB/2011.16. WHO, Geneva, Switzerland. World Health Organization. 2010. Global TB Database. 2010. (Online) (Cited 2011, Sept 4). Available from URL: www.who.int/tb/data. World Health Organization.2010. Multidrug and extensively drug-resistant TB (M/XDR-TB): 2010 global report on surveillance and response. (Online) (Cited 2011 Sep 4). Available from URL: http://whqlibdoc.who.int/publications/2010/97892415991 91_eng.pdf. World Health Organization. 2012. Global tuberculosis report. Retrieved 2013 from, http://www.who.int/tb/publications/global_report/2011/gt br11_executive_summary.pdf. 160