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tuberculosis in madagascar
Madagascar, a country off the southeastern coast of Africa, comprises of tuberculosis cases among its citizens of low socioeconomic status. In 2012, 70.7% of the Malagasy population was living below the poverty line and in 2017, the incidence rate for tuberculosis in Madagascar was 233 cases per 100,000 people. Encouraged and perpetuated by poverty, this disease makes Madagascar the perfect candidate for an outbreak.

Tuberculosis, commonly known as TB, is the most infectious fatal disease in the world. Although it is a very treatable illness, it kills more than 1 million people annually across the globe. The vast majority of TB diagnoses and deaths derive from individuals residing in poor, developing nations.

Risk Factors

Lack of quality living conditions, nutrition and healthcare amplify the risk of getting tuberculosis in Madagascar. Limited access to toilets and handwashing facilities for the majority of Malagasy people have left many at risk. According to CIA World Factbook data, sanitation facility accessibility in Madagascar was unimproved for 88% of the total population in 2015. TB is also the leading cause of death for people with HIV. As of 2018, there were roughly 39,000 Malagasy people diagnosed with HIV but only 20,865 known TB cases that also had documented HIV statuses. Without quality systems in place to document HIV and TB rates across the country, solving the epidemic in Madagascar will not be easy.

The Global Fund Support

The added historical stigma surrounding TB makes matters worse. While already struggling financially, patients often fear that exposing their diagnosis will cause them to lose their jobs. This stigma is combated through support systems like The Global Fund, an organization that provides relief for epidemics through fundraising and education for those affected by TB. The fund’s employees act as a support system, thus debunking the shame that infected patients may feel due to their diagnosis.

In 2018, The Global Fund’s donations and work helped cure 33,000 patients with tuberculosis in Madagascar. For 2020-2022, the organization projects that a total of $18,045,448 will go toward tuberculosis management in Madagascar. In 2017, these funds helped increase Madagascar’s TB treatment success rate to 84%.

Biotechnological Solutions

Although TB is preventable and curable, Madagascar lacks the necessary medical tools to diagnose and treat this disease. Not only are there minimal supplies, but there is also a need to expand and strengthen Madagascar’s ability to analyze TB samples according to Niaina Rakotosamimanana, the head of the mycobacteria unit at the Health Institute of Madagascar.

Researchers from the Health Institute of Madagascar, Stony Brook University and Oxford University are also collaborating to find solutions for this issue. These institutions are working together to grant access to a portable and affordable tool, the MinION. The MinION helps to diagnose and efficiently test the resistance of TB strains to antibiotics, while at the same time being a cheap, affordable option that is accessible to Malagasy people.

Tuberculosis is still one of the top 10 leading causes of death in Madagascar, but the country is making significant progress towards the eradication of the disease. The efforts Madagascar is taking in tracking TB are positive steps that contribute to the fight against this epidemic.

Sophia McGrath
Photo: Pixabay

Tuberculosis in Madagascar
Tuberculosis, commonly known as TB, is the most infectious fatal disease in the world. Despite the fact that it is treatable, TB kills more than 1 million people annually across the globe. The wide majority of diagnoses and deaths occur in poor, developing nations. Here is some information about tuberculosis in Madagascar.

Tuberculosis in Madagascar

Tuberculosis cases plague Madagascar, a country off the southeastern coast of Africa, especially among the citizens of low socioeconomic status. As of 2012, 70.7% of the Malagasy population lived below the poverty line. As a result, in 2017, the tuberculosis incidence rate in Madagascar was 233 cases per 100,000 people. TB is a disease that poverty perpetuates, making Madagascar a likely candidate for an outbreak.

Lack of quality living conditions, nutrition and health care all amplify the risk of tuberculosis infection in Madagascar. Proper toilets and handwashing facilities are scarce for the majority of Malagasy people. According to CIA World Factbook data, as of 2015, sanitation facility access in Madagascar remained unimproved for 88% of the total population. As for health care, not only is TB deadly in itself if it does not receive treatment, but it is the leading cause of death for people who suffer from HIV. As of 2018, there are 39,000 Malagasy people who receive a diagnosis of HIV, however, only 20,865 TB patients also had documentation of their HIV status. Without quality systems in place to document HIV and TB status, solving the epidemic in Madagascar will not succeed.

The Global Fund’s Support

The added historical stigma surrounding TB makes matters worse. While already struggling monetarily, patients are often fearful that, if their diagnosis is public, they will risk losing their jobs. However, various groups are making progress in reducing this stigma while aiding those with TB. The Global Fund, an organization that assists in funding relief for epidemics, is hiring employees to administer medication and encourage TB patients in Madagascar to stay on track with their antibiotics. These employees act as a support system as well and are working to debunk the shame that patients may feel surrounding their diagnosis.

The Global Fund is continuing to make huge strides in combating this disease. In 2018, the organization funded the cure of 33,000 patients in Madagascar. For 2020-2022, there is a projected $18,045,448 that will contribute to tuberculosis health care in Madagascar. These huge sums of money should significantly diminish the problem. As of 2017, based on the recorded percentage of new cases of TB, the treatment success rate was 84%.

Biotechnological Solutions

Although the disease is incredibly preventable and curable, there is a lack of medical tools in Madagascar necessary to diagnose and treat TB. Not only are there minimal supplies, but the head of the mycobacteria unit at the Health Institute of Madagascar, Niaina Rakotosamimanana, said that “we have a collection of [TB] strains at the Pasteur Institute… about 9,000 strains. We have been thinking about expanding and strengthening our ability to analyze those samples.”

Researchers from the Health Institute of Madagascar, Stony Brook University and Oxford University are collaborating to help grant greater access to a portable and affordable tool, the MinION. The MinION helps to diagnose and efficiently test the resistance of TB strains to antibiotics. It is a cheap, affordable option that is accessible to Malagasy people. While developed countries have the technology to create complex, expensive tools to prevent the spread of TB, low-income countries, where the disease is affecting more people, have considerably less information. Because developing nations often cannot support Western medical technology, tools like the MinION are incredibly beneficial.

Tuberculosis in Madagascar is still one of the top 10 leading causes of death in the country, but Madagascar is making significant progress towards the elimination of the disease. The efforts Madagascar is taking in tracking TB are positive steps contributing to the mitigation of the epidemic.

Sophia McGrath
Photo: Flickr