Tuberculosis in India and Australia: A Comparative Analysis

Subject: Pulmonology
Pages: 7
Words: 1995
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8 min

Introduction

Tuberculosis is a serious disease that causes death if treatment is not sought at the early stage. The disease is transmitted in almost all settings implying that proper hygiene and other preventive measures play a critical role in keeping off the spread of the disease. Healthy individuals are at risk of contracting the disease in case they are exposed to the affected individuals. In 1960s, countries utilized isoniazed drugs to cure the disease because it was very effective. Moreover, the drug was cost effective and safe as compared to other forms of drugs in the market. However, the drug is no longer effective in curing the disease because of the multidrug-resistant tuberculosis (Agrawal, Udwadia, Rodriguez, & Mehta, 2009). A number of countries have come up with policies and practices aiming at containing the influence of the disease in society. Policies and practices employed and applied by Australia and India is discussed in detail in this paper.

The paper compares and contrasts the policies and practices in the two countries. In Australia, studies show that healthcare providers are in risk of contracting the disease due to the policies and practices applied. Therefore, the policies established aim at identifying and separating those suffering from the disease from other healthy members of the society. In the country, people suffering from the disease are taken care in hospitals and clinics, as compared to India whereby patients are taken care of by their relatives in homes. In Australia, policies and practices are well-established because it is perceived that those taking care of the sick are at high risk of contracting the disease. Policies have been designed specifically to cater for the interests of the healthcare providers.

Tuberculosis Infectivity Management Policies in the Two State

In the two nations, management policies are based on a systematic evaluation of spread risks, either in the facility or in homes. In this regard, priority is always given to policies aiming at detecting the disease at an early stage because it is easy to manage it a tender stage. Upon detection of the disease, those with the symptoms of the disease are usually isolated in Australia in order to prevent further spread. This practice is usually considered a precaution because the disease is easily transmitted through the air. In both countries, the treatment of the disease takes place after detection and isolation. It should be noted that policies and practices aiming at preventing the spread of the disease in the two countries are similar. However, the level of supervision, funding, support, and monitoring are different. While the main concern of Australia is to detect the cases of tuberculosis in society, the main concern of India is ensuring that technical excellence is achieved in the treatment of the disease (Vijay, Swaminathan, & Vaidyanathan, 2009).

As earlier stated, all sick individuals are taken to hospitals, clinics, emergency care giving centers, correctional facilities, home-based healthcare centers, long-term care centers, outreach settings, and homeless shelters in Australia. This is not the case in India because the sick are taken care of by their individual families mainly because many people are unable to afford the costs associated with specialized care. Moreover, the government is yet to come up with extensive policies aiming at helping those suffering from the disease. Caregivers are perceived to be in danger of contracting the disease because they interact with the sick quite often. The main worries of the government are that those suffering from the disease and are not yet diagnosed pose a great danger to the healthy population. Policies are therefore made to ensure that those with the disease and are not diagnosed are identify as quickly as possible to avoid any further infection. In the care giving institutions, those with the disease are usually identified, secluded, estranged, and relocated to prevent patient-patient transmission. In any care giving institution, caregivers are trained to diagnose the disease before proceeding to offer any form of help. In diagnosing the disease, some of the symptoms are usually observed, including frequent coughing, which is usually longer than three weeks, extreme pains around the chest, bloody sputum, serious loss of weight, persistent fever, colds, sweating in the night, malaise, and exhaustion. As compared to Australia, the main concern of the government is offering adequate training to the medical personnel to be able to diagnose the disease. The family is relied upon to assess the progress of the patient, even though a specialist is assigned the responsibility of ensuring that the patient receives adequate care (Vikram, 2008).

The main drugs used in India are the DOTS. Treatment in India is given on an intermittent basis meaning that there is no stable system of drug administration. The main problem affecting the Indian government is misappropriation of funds and the establishment of ineffective policies. In any society, the government is usually charged with the responsibility of ensuring that the public receives specialized healthcare. In India, the provision of health has been waning and waxing over years meaning that those suffering from tuberculosis are the most affected. In this regard, the government of India has embarked on a thorough campaign aiming at stamping authority over administration of tuberculosis drugs. The policies being designed serve as pilot programs, which would be used as models for implementing large-scale projects. Recently, the government gave the agency in charge of monitoring tuberculosis powers and resources to deal with the disease. The newly created Central Tuberculosis Division has played a critical role in formulating policies and offering technical support to other agencies and organizations dealing with the widespread problem of tuberculosis in the country. Through the agency, a workforce that is committed to eradication of tuberculosis has emerged. Accountability and fairness is advocated among members of the agency. Recently, the programs aiming at eradicating tuberculosis received a funding of over $142 million from the World Bank. The funds have helped in the formulation of policies aimed at controlling the spread of tuberculosis in the country. While India is struggling with the issues related to funding, policies are being made in Australia aimed at providing airborne infection isolation room, which would be in hosting a single patient suspected to be suffering from tuberculosis (Pang, 1996). This would definitely minimize the transmission of the disease in society. Through the airborne infection segregation space, the caregivers would have a chance to manage the ecological aspects in order to reduce the transmission of the contagious agents. This shows that funding is an important factor to consider when designing policies aimed at kicking out tuberculosis. Developing countries have always struggled to prevent communicable diseases because of insufficient funding.

In Australia, a common practice among caregivers is that all patients diagnosed with tuberculosis should be treated irrespective of whether the patient is in a position to pay for the services (Small, & Madhukar, 2010). It is generally agreed that those suffering from tuberculosis pose a serious threat to the security of the society. The disease is highly communicable meaning that other members of society can easily contract it. Therefore, it is the responsibility of the government to provide funds for treating the disease. In other words, the Australian caregivers are driven by the principle that they have to maintain focus and prioritize on the most pressing issue as far as healthcare is concerned. In this regard, three policies are always advocated in the Australian society. One of them is operational research whereby healthcare providers engage in constant research aimed at coming up with the best policies and practices as regards to controlling tuberculosis. This comes upon realization that program improvement relies heavily on continuous research. However, it is always insisted that implementation of the program should adhere to the set rules and standards. Unlike in India, the Australian government involves all stakeholders in implementing policies aimed at controlling the spread of tuberculosis in the country. In India, the private sector has been given the responsibility of disseminating drugs for curing tuberculosis. This is unfair because private practitioners tend to charge exorbitant prices, which forces the poor to seek alternative medicine that are sometimes ineffective. In any society, the government should always control the provision of essential services, which are sensitive to the national security (Shushum, Tsegyal, & Rowleyb, 2002). In Australia, the government monitors the administration of tuberculosis drug, although the private sector has a little to play. In India, a public DOTS program should be established aiming at providing the drugs to the population without discrimination. The Indian government should therefore take control of the program and define the role of the private sector. Finally, the Australian society has established a clear policy as regards to identification of areas of focus. This has helped in identifying the problems facing patients in all parts of the country.

TB Infection Control Programs

A big difference exists between policies and practices employed in India and those applied in Australia. In Australia, programs aimed at controlling the disease are divided into three major segments. They include administrative controls, environmental controls, and respiratory controls. However, India does not have specific policies and practices aimed at controlling the disease. In fact, people rely on traditional control mechanisms and practices, which are highly ineffective. Administrative controls are meant to reduce the risk at which an individual is exposed to tuberculosis. Ecological management strategies are employed majorly to prevent the absorption of globule nuclei. Finally, the Australian society employs respiratory control policies mainly to reduce the spread of the disease in certain areas. While Australians employ administrative policies to contain the effects of the disease in society.

Regarding administrative control, a number of policies are administered. Unlike in the Indian society whereby people with tuberculosis are allowed to interact freely in society, the Australian society assigns caregivers the responsibility of ensuring that infection control is perfected in any setting. Moreover, the caregiver is always assigned the role of ensuring that infection control assessment is undertaken in any setting. Apart from using the services of caregivers, the government has established a plan, which outlines the procedures related to detection, separation, and treatment of the affected. Moreover, it is the responsibility of the regime under the administrative control policy to provide the suggested laboratory dispensation and testing apparatus. In India, the government is reluctant to intervene even though private care providers are known to exploit patients. Since the government recommended the use of DOTS, it has been reluctant to conduct an evaluation to determine its effectiveness in the public domain. In many Indian hospitals, patients cannot access the drugs because of mismanagement. Patients report that drugs are unavailable in hospitals because private practitioners ensure that they create made-made artificial shortages (Udwadia, Pinto, & Uplekar, 2010). In many cases, patients experience interrupted treatment, leading to serious complications. In Australia, shortage of drugs can never be reported because those charged with service delivery in the health sector are imbued to service delivery.

There is a major difference, as regards to the way the Australian society controls the spread of the disease from one person to the other in the public exists. The healthcare providers utilize both primary and secondary sources in controlling the spread of tuberculosis. Primary environmental control entails the use of general ventilation whereby windows are opened. Moreover, the use of mechanical ventilation is also common. In India, the government is struggling to come up with infrastructural plans that would help in controlling the spread of the disease. The revised National Tuberculosis Program aims at equipping each hospital with a medical staff specializing in the prevention of the disease.

Conclusion

It can be concluded that India has a long way to go far as prevention of tuberculosis is concerned. Australia has instituted the best policies and practices aimed at containing the spread of the disease. In India, the government is yet to take full authority over the health of its citizens. Private organizations are accused of monopolizing the distribution of tuberculosis drugs, which is a major threat to the health of citizens.

References

Agrawal, D., Udwadia, Z., Rodriguez, C., & Mehta, A. (2009). Increasing incidence of Fluoroquinolone-resistant Mycobacterium tuberculosis in Mumbai, India. International Journal of Tuberculosis &Lung Disorder, 13(1), 79–83.

Pang, S.C. (1996). Tuberculosis Control in Western Australia. Perth, W.A: Westcare.

Shushum, B., Tsegyal, D., & Rowleyb, D. (2002). Tuberculosis among Tibetan refugees in India. Social Science & Medicine, 54(1), 423–432

Small, M., & Madhukar, P. (2010). Tuberculosis Diagnosis, Time for a Game Change. New England Journal of Medicine, 363(11), 1070-1504.

Udwadia, Z., Pinto, L., & Uplekar, M. (2010). Tuberculosis Management by Private Practitioners in Mumbai, India: Has Anything Changed in Two Decades? PLoS ONE, 5(8), 1-5.

Vijay, S., Swaminathan, S., & Vaidyanathan, T. (2009). Feasibility of Provider-Initiated HIV Testing and Counseling of Tuberculosis Patients under the TB Control Program in Two Districts of South India. PLoS ONE, 4(11), 1-7.

Vikram, P. (2008). Worlds Apart, Tuberculosis in India and the United States. New England Journal of Medicine, 358(11), 1092-1095.