TB in Moldova – Myths and Reality

Burdened with worryingly high levels of infection, this country needs to cast off the misinformation and ignorance about tuberculosis. From Bas-TV.

The disease of the poor! This is what doctors once dubbed tuberculosis, on the basis that malnutrition and inadequate living conditions are the main drivers of the disease. Tuberculosis is an infectious disease which, in terms of mortality rates, is only surpassed in Moldova by HIV, according to medical specialists.

World Health Organization data shows that a third of the world’s population is infected with Mycobacterium tuberculosis, the microbe that causes TB. Around 10 percent of the population risks having the latent infection progress to the active stage of the disease.

Moldova is one of 18 countries in Europe and Central Asia with a high rate of TB infection, and among the first 30 countries worldwide with the highest occurrence of multidrug-resistant TB. According to Alexandra Sevcenco, a pulmonologist from the Basarabeasca district in southern Moldova, the country is considered at high risk from an epidemiological point of view, and an infection hotspot for TB. Around 90 percent of the Moldovan population is believed to be infected with TB. And the symptoms of the disease can be easily mistaken for those of a common cold. 

Alexandra Sevcenco, pulmonologist: “The main symptoms of TB infection are a prolonged cough – for three weeks or longer – often, but not always high fever, and weakness. TB symptoms are similar to the symptoms of a common cold, or of pneumonia, bronchitis, or flu.”

Veronica Oprea, family doctor: “We diagnose tuberculosis either in people who come to us, or in people we examine while on house calls. High-risk groups include migrants, people infected with HIV, socially vulnerable people, drug addicts, people suffering from psychiatric diseases, people with type 1 diabetes, and people living together with others infected with TB.”

“Very often, people don’t come to the doctor on time, because the onset of the disease is very sneaky, and other diseases may resemble it,” Sevcenco says. “Only X-rays or a microscopic analysis of sputum can confirm whether someone has TB.”

The law requires those at high risk of TB infection to have annual pulmonary X-rays. Another diagnostic method was made possible through “A doctor for you,” a nationwide campaign to gather information on the health of rural Moldovans. Belarus helped the campaign with a donation of a mobile lung X-ray machine to the Chiril Draganciuc Institute of Phthisiopneumology in Chisinau.

COVID Fears Drive Patients Away From TB Clinics

According to doctors, the statistics show a decline in TB patients from 2019 to 2020 not because there are fewer cases of tuberculosis, but because COVID-19 has taken the spotlight. Tuberculosis is a poor person’s disease, and pulmonologists say it has always been present in critical situations. Many people wonder if there is a treatment for it. Of course there is, specialists say. The best prophylactic measure is timely detection, especially considering that only between 5 and 10 percent of people who are infected get ill.

Maria Arvat, a social worker at the Basarabeasca Support Center for TB Treatment, explains that center staff inquire about patients’ psychological problems; the center has a psychologist who gives therapy sessions both for patients and their relatives, because the family plays a crucial role in persuading someone to stay the full course of treatment.

Visits to patients’ houses enable center staff to assess their living conditions. In the event of social problems, the center can file cases on their behalf to local city halls or district councils, Arvat says. They also visit village halls, because local government bodies know who is ill among the local population and can offer a more accurate picture.

A number of civil society groups offer support to those with TB. Speranta Terrei (Hope for the Earth) has been active in the northern city of Balti for more than a decade, providing free examinations, treatment, and psychological support. Former clients speak of the importance of the work done by volunteers; some have volunteered themselves.

Specialists say we should change the mindset that tuberculosis is far from us, or doesn’t have anything to do with us. In reality, tuberculosis is a disease that doesn’t care about someone’s gender, age, education, or income. There are people with the disease in every country and on every continent, regardless of their race or nationality. Patients with TB can be young or old, tall or short. Some are well-educated, but others can’t read or write. Some are rich, others are poor. According to the last World Health Organization report, each year around 9 million people get tuberculosis. Each day, around 1,000 people catch the disease; in Europe, as well as in our country, the trend is falling.

10 Myths About TB

1. Only “marginal people” get tuberculosis – people with an asocial lifestyle, alcoholics, drug addicts, or those who live in poverty.
2. Tuberculosis can be treated, but it can’t be cured.
3. You can catch TB by sitting next to an infected person on a bus.
4. Prisons and homeless people are the two main “reservoirs” of tuberculosis.
5. The treatment is very expensive and lasts for years.
6. The free treatments provided by hospitals are the cheapest on the market, meant for third-world countries, and are not effective.
7. Tuberculosis can be treated using folk remedies.
8. It’s better to avoid all treatment and just live as long as you were meant to than to undergo treatment and ruin your health with the medication.
9. There is no effective vaccine for TB. Vaccinating children is useless and can even cause harm.
10.  If we are to make progress in the fight against tuberculosis, it is necessary to return to mass screenings and X-rays.

A version of this article by Tatiana Casim originally appeared in Romanian on the website of Bas-TV, a Moldovan TV channel serving the Basarabeasca district. Bas-TV has added additional material.

Translated by Ioana Caloianu.