Tuesday, October 11, 2011

WHO Says India Leads the World in TB Cases

India led the world with an estimated one quarter (26%, up from about 20% in previous years) of all TB cases, and China and India combined accounted for 38% of the global cases in 2010, according to the World Health Organization 2011 report titled "Global Tuberculosis Control 2011". The top five countries with the largest number of reported cases in 2010 were India (2.0 million–2.5 million), China (0.9 million–1.2 million), South Africa (0.40 million–0.59 million), Indonesia (0.37 million–0.54 million) and Pakistan (0.33 million–0.48 million).

The good news the WHO report offers is that TB rates are dropping for the first time. The number of TB cases fell from a high of 9 million in 2005 to 8.8 million in 2010. TB deaths dropped from 1.8 million in 2003 to 1.4 million in 2010, and the death rate plummeted 40% from 1990 to 2010. Cure rates are high -- in 2009, 87% of people who had TB were cured, but the report also found that a third of likely TB cases are never notified, so it's not known if those people were diagnosed and treated.

A number of countries have shown that the extra focus on fighting the disease pays off. Kenya, Tanzania and Brazil have all seen TB rates decline in the last 10 to 20 years. China's progress has been substantial, with death rates dropping by almost 80% from 1990 to 2010. The frequency of TB was also cut in half in that time.

Beyond TB, infectious diseases like malaria and dengue fever continue to take a heavy toll in developing nations. Over the past two months, dengue fever has killed 202 people in Pakistan and another 12,000 have been infected, according to Pakistani health officials. India has reported about 28,500 cases of malaria and at least 10 deaths in New Delhi, Andhra Pradesh, Haryana and Mumbai cumulatively this year. In India's Gujarat State 8228 cases have been confirmed in the last few weeks.

Poverty, hunger, unsanitary or unsafe conditions and inadequate health care in South Asia's developing nations are exposing their citizens to high risk of a variety of diseases which may impact their intelligence. Every year, World Health Organization reports what it calls "Environmental Burden of Disease" in each country of the world in terms of disability adjusted life years (DALYs) per 1000 people and total number of deaths from diseases ranging from diarrhea and other infectious diseases to heart disease, road traffic injuries and different forms of cancer.



In the range of DALYs/1000 capita from 13 (lowest) to 289 (highest), WHO's latest data indicates that India is at 65 while Pakistan is slightly better at 58. In terms of total number of deaths per year from disease, India stands at 2.7 million deaths while Pakistani death toll is 318, 400 people. Among other South Asian nations, Afghanistan's DALYs/1000 is 255, Bangladesh 64 and Sri Lanka 61. By contrast, the DALYs/1000 figures are 14 for Singapore and 32 for China.

Recent research shows that there are potentially far reaching negative consequences for nations carrying high levels of disease burdens causing lower average intelligence among their current and future generations.

Published by the University of New Mexico and reported by Newsweek, new research shows that there is a link between lower IQs and prevalence of infectious diseases. Comparing data on national “disease burdens” (life years lost due to infectious diseases or DALYs) with average intelligence scores, the authors found a striking inverse correlation—around 67 percent. They also found that the cognitive ability is rising in some countries than in others, and IQ scores have risen as nations develop—a phenomenon known as the “Flynn effect.”



According to the UNM study's author Christopher Eppig and his colleagues, the human brain is the “most costly organ in the human body.” The Newsweek article adds that the "brainpower gobbles up close to 90 percent of a newborn’s energy. It stands to reason, then, that if something interferes with energy intake while the brain is growing, the impact could be serious and longlasting. And for vast swaths of the globe, the biggest threat to a child’s body—and hence brain—is parasitic infection. These illnesses threaten brain development in several ways. They can directly attack live tissue, which the body must then strain to replace. They can invade the digestive tract and block nutritional uptake. They can hijack the body’s cells for their own reproduction. And then there’s the energy diverted to the immune system to fight the infection. Out of all the parasites, the diarrheal ones may be the gravest threat—they can prevent the body from getting any nutrients at all".

Looking at the situation in South Asia, it appears from the WHO data that Pakistan is doing a bit better than India in 12 out of 14 disease groups ranging from diarrhea to heart disease to intentional injuries, and it is equal for the remaining two (Malaria and Asthma).

A detailed WHO report on World Health Statistics for 2010 assesses and compares its member nations on the basis of nine criteria including mortality and burden of disease, cause-specific mortality, selected infectious diseases, health service coverage, risk factors, health workforce-infrastructure, health expenditures and demographic and socioeconomic statistics. It shows that both India and Pakistan have some serious challenges to overcome to have any chance of meeting health-related Millennium Development Goals (MDGs 4, 5 and 6).

Related Links:

Haq's Musings

India and Pakistan Compared in 2011

Indians and Pakistanis Suffer Heavy Disease Burdens

India Leads the World in Open Defecation

Infectious Diseases Kill Millions in South Asia

Infectious Diseases Cause Low IQ

Malnutrition Challenge in India and Pakistan

Hunger: India's Growth Story

WHO Report 2010 Blogger Analysis

Syeda Hamida of Indian Planning Commission Says India Worse Than Pakistan and Bangladesh

Global Hunger Index Report 2009

Grinding Poverty in Resurgent India

WRI Report on BOP Housing Market

Food, Clothing and Shelter For All

India's Family Health Survey

Is India a Nutritional Weakling?

Asian Gains in World's Top Universities

South Asia Slipping in Human Development

8 comments:

Anonymous said...

Riaz if you check your own figures Pakistan has more TB cases on a per capita basis...

Riaz Haq said...

Anon: "Riaz if you check your own figures Pakistan has more TB cases on a per capita basis..."

Depending on which end of the range you compare, the per capita rates are about the same or slightly higher in Pakistan. And the overall disease burden in Pakistan is lower, according to WHO data.

In the range of DALYs/1000 capita from 13 (lowest) to 289 (highest), WHO's latest data indicates that India is at 65 while Pakistan is slightly better at 58. In terms of total number of deaths per year from disease, India stands at 2.7 million deaths while Pakistani death toll is 318, 400 people. Among other South Asian nations, Afghanistan's DALYs/1000 is 255, Bangladesh 64 and Sri Lanka 61. By contrast, the DALYs/1000 figures are 14 for Singapore and 32 for China.

It's also clear from the WHO data that Pakistan is doing a bit better than India in 12 out of 14 disease groups ranging from diarrhea to heart disease to intentional injuries, and it is equal for the remaining two (Malaria and Asthma).

satwa gunam said...

@riaz

I think we are giving too much importance to international organization. I think there are lot of errors in the way in which the data is collected, collated and publish.

Please go through the data which sounds illogical. HOw can the death rate be more than 1000 when the calculation itself is for a base of 1000

Number of under-five deaths (thousands)
India 1696
pakistan 423


Number of infant deaths (thousands)

India 1305
pakistan 347

http://apps.who.int/ghodata/#

As for as the health concern is concerned, india has to go a long way as the bpl itself is very high.

Riaz Haq said...

Satwa: "Please go through the data which sounds illogical. HOw can the death rate be more than 1000 when the calculation itself is for a base of 1000"

You are not reading it correctly.

Number of under-five deaths (thousands)
India 1696
pakistan 423

1695 means 1.695 million deaths in India.

And 423 means 423,000 deaths in Pakistan.

It just shows Pakistan has higher infant mortality rate than India based on these 2004 figures.

satwa gunam said...

@riaz

Thanks for the feedback. If that be the case, the comparision must be against the total population:

India : 1,189,172,906
Pak : 187,342,721

On comparision on this base, it is 0.15% for india and 0.23% for pakistan.

Mayraj said...

http://tribune.com.pk/story/274643/encephalitis-kills-at-least-430-in-india/
Encephalitis kills at least 430 in India

Riaz Haq said...

Here's an APP report on the use of technology by US to teach and treat in Pakistan:

U.S. Ambassador to Pakistan Cameron Munter Thursday highlighting Pak-US cooperation in science and technology said that it has trained more than 100 doctors nationwide, and treated more than 2,000 patients remotely through the use of cutting-edge technology. During his visit here Thursday the Ambassador and his wife Marilyn Wyatt met with the faculty and students of the Rawalpindi Medical College at Holy Family Hospital’s telemedicine facility, working together with U.S. hospitals.

He said Pak-US cooperation in science and technology focused on many elements, including innovations in Pakistan’s public health sector. During a tour of the hospital with the hospital’s Telemedicine E-Health Training Center Project Director Dr. Asif Zafar, Ambassador Munter stated, “Holy Family’s partnership with American hospitals is an example of the true spirit of our people, who work together, across oceans, to improve access to healthcare in remote areas of Pakistan and treat the sick.” He said, “We commend Dr. Asif Zafar and the Holy Family Hospital team for its efforts to strengthen the health sector in Pakistan, and look forward to more shared successes that bring Pakistanis and Americans closer together.”


http://pakobserver.net/detailnews.asp?id=134092

Riaz Haq said...

Here's a Guardian story on how Pakistani Punjab is fighting dengue fever using tilapia fish:

On one side of the battle are the countless swarms of mosquitoes that thrive in Pakistan's steamy summer months. On the other, vast quantities of hungry fish conscripted into a fight against a deadly virus that is reaching epidemic proportions.

Authorities battling the menace of Dengue virus claim to have turned the tide against the mosquitoes that carry the disease with the help of 1.6m fish released this year into pools, puddles, fountains and any other potential insect breeding places they can find.

Punjab has waged an all-out campaign against Dengue – a potentially lethal disease spread by mosquito bites – since a major outbreak in 2011 infected tens of thousands and killed more than 300 people.

Software designers were tasked to make smartphone apps to track outbreaks, the government cracked down hard on anyone who left old tires in areas where they could collect rainwater, and areas of stagnant water were doused with tons of noxious chemicals.

But it's the release of huge numbers of fish, even into water that soon evaporates, that many credit with helping to beat back the disease, which is now surging in other areas of the country.

"It's much better than chemicals that poison the environment," said Dr Mohammad Ayub, the director general of Punjab's fisheries department. "And anyway, chemicals soon get washed away by the rain."

A typical target the Punjab's fish team is an acre of murky water that forms every year in a depression squeezed between a flyover and brick factory in an unlovely outskirt of Lahore.

It is one of the hundreds of glorified puddles that fill during the monsoon season that are of little interest to anyone apart from wallowing water buffalos that make their home there.

Every few months a team led by a white bearded technician in an lab coat return to the pool, test the water and then release up to a thousand voracious tilapia fish from giant plastic bags partially inflated with oxygen.

Immediately on their release the surface of the water ripples with fish rising to gobble insects and the larvae that would otherwise quickly mature into mosquitoes.

The war on mosquitoes has demanded a significant effort by Punjab's fisheries department, which runs hatcheries to breed the vast quantities of fish seed required to keep mosquitoes at bay.

The effect has been dramatic with just over 100 cases reported in Punjab this year, compared with 20,000 in 2011. Officials say it has also curbed other pests, not just the Aedes mosquito that carries Dengue.

"Previously people could not sit outside in evenings on lawns but now they can sit comfortably because there are no mosquitoes," said Ayub.


http://www.theguardian.com/world/2013/oct/01/punjab-fish-dengue-mosquito