Increase in the number of Region 10 screenings for TB so more cases detected

Dear Editor,

I wish to refer to your article dated November 3, 2012 under the caption ‘Concerns raised over TB prevalence in Linden, poor conditions at hospitals.’
Firstly I wish to empathically state that there is no outbreak of tuberculosis in Linden Region 10 and it was abhorrently irresponsible and immature to cause the Guyanese public and moreover the Linden community such alarm. However, what we have seen is an increase in the number of screenings being done, as a consequence of which more cases are being detected and treated. Staff members from the Upper Demerara Hospital who are attached to the Chest clinic have been doing several outreaches to far-flung areas such as Kwakwani, Aroaima, Malali, Muritaro, Hururu and others areas.  These visits have unearthed some new cases of tuberculosis and they are being adequately treated and managed.

Moreover, once a tuberculosis case has been detected in a specific area that entire area is targeted for screening and educational sessions on the disease.
Also, through the Georgetown Chest Clinic dietary supplements are provided for persons who are co-infected with TB/HIV, as well as those families who are from a low socio-economic backgrounds.  It is important to note that not because one case is discovered in a community the entire community has the tuberculosis disease; what we are detecting is a lot of persons being diagnosed with the tuberculosis infection, which just means that those persons have been exposed to the disease. Sporadically, those cases evolve into the tuberculosis disease.   Additionally, through the availability and efforts of a dedicated doctor (Dr Roscoe McDonald) in Region 10, all TB and TB/ HIV co-infected cases are now managed by the Regional hospital as an alternative to the Georgetown Chest Clinic. Consequently it may also seem that there is an increase in the number of cases in Region 10 because the co-infected cases are no longer managed in Georgetown.

Please see the attached table below showing the new TB cases diagnosed in Region 10 for January to September 2011 and up to September, 2012. The number of new TB cases detected so far for 2012 has significantly declined when compared to the same period in 2011. The trends have shown that the number of co-infected cases in Region 10 increased from 9 in 2011 to 13 cases thus far for 2012.  The National Tuberculosis Programme has noted that there will be a likely increase in the detection of TB cases in areas that are more highly populated such as towns and that the low socioeconomic status of some households is also a factor. A similar pattern is seen in Region 4 (Georgetown area) which has the highest burden of TB cases (60%).

Health care workers who are attached to the Chest Clinic at the Upper Demerara Hospital have been in the system for a number of years; they have been exposed to but have never tested positive for the TB disease. It is a known fact that in a developing country there will be exposure to TB and about one-third of the population may have latent TB infection which can show up in screening, although only 10% of persons with latent TB infection will fall sick with the disease.

In rejoinder to the subject of poor sanitation, the entire Upper Demerara Hospital is sanitised and cleaned daily basis by the hospital’s cleaning staff.  We do adhere to strict sanitation guidelines and policies defined by our Occupational Safety and Health Department. Nurses who are assigned to the infectious ward are given a special mask which lasts for approximately eight hours; additionally,  patients who are on the ward are given normal face masks which helps to eliminate the spread of the TB germ into the atmosphere. Stricter control measures are enforced when we are not in receipt of those special face masks for the nurses.

The Upper Demerara Hospital falls under the auspices of the Regional Democratic Council. The council is responsible for all infrastructural works on the building, while the Linden Hospital Complex supplies the medical staff to run the institution. Attempts to upgrade the existing structure have been made by the Region and we have seen some improvement at the hospital; however, some works have been put on standstill but we are committed to delivering medical service to the community of Wismar.

Despite works being stalled the dedicated staff  have been providing laudable medical service on a daily basis at the institution. The ingenuity and improvisation of the our Board of Directors and staff members have aided us significantly in remedying and correcting numerous quandaries that could have spiralled out of control and disrupted the services provided by the hospital.

We continue to offer medical services to the Linden community as we endeavour to provide a high quality of health care service through team work and with compassionate care.

National Tuberculosis Programme Statistical Information for Region 10

January to December, 2011
Number of New TB cases registered       70
Number TB/HIV cases registered              9

 January to September, 2012
Number of New TB cases registered      56
Number TB/HIV cases registered          13

Yours faithfully,
Reycia Nedd
Public Relations Officer
Linden Hospital Complex

Editor’s note
Our story did not refer to an “outbreak” of TB; it reported regional leaders as calling for an investigation into the “treatment and care of patients” with the disease at Linden hospitals, and for a study into the “prevalence” of tuberculosis in Region 10. Furthermore, we also reported the administration of the Linden Hospital Complex as saying there was no need for alarm.

We stand by our report on the Upper Demerara Hospital.