TB cases down but arguments over numbers persist

The Palestinians' lack of control over their borders plays a small but not negligible role in the low tuberculosis rates in the occupied Palestinian territory (oPt), health officials said.

[Read this report in Arabic]

Israel's jurisdiction over all crossing points, with its own system of screening and treatment, helps keep rates in the Jewish state down to about 5.7 per 100,000, an Israeli Ministry of Health official said.

In the oPt, a tightly enforced vaccination system, easy access to anti-TB drugs and a low number of HIV/AIDS patients, are the main reasons for the few outbreaks.

Efforts by UNRWA, the UN agency for Palestinian refugees, such as inoculation programmes dating back to the 1950s, are additionally credited as being effective. These were complemented by the governmental system set up by the Palestinian Authority shortly after its creation in the 1990s.

By keeping the number of cases down, the numbers stay down, particularly as there is virtually no immigration into the oPt and contact between the Palestinians there and residents of countries with high tuberculosis rates are relatively minimal, the Palestinian ministry of health said.

However, the officially published estimates of the World Health Organization (WHO) for 2006, which said there were about 20 cases per 100,000 residents, are disputed by the Palestinian ministry of health, which declined to give an exact number but said there were far fewer.

Asad Ramlawi from the ministry of health’s preventative medicine department said that although the rate of detection was still less than ideal, and some cases went unobserved, he did not believe it was nearly as high as the published statistics.

"We need to train more doctors in the detection of TB," said a local physician who works in preventative medicine.

Immigration

Israel, however, does have immigration from countries with high TB rates, like Ethiopia (the law offers citizenship to all Jews).

Daniel Shem Tov from the Israeli Ministry of Health said it had very tight procedures for monitoring patients, as well as those who might have been exposed to someone with an active virus. This enabled it to offer preventative treatment, particularly as it did not run a vaccination programme.

A recent influx of asylum-seekers from Africa to Israel has also added a few cases of TB to the local caseload. Shem Tov said the state continued to offer free testing and screening for all, including undocumented migrants.

shg/ar/cb