Infectious Diseases on the Rise

Every year, more people die of tuberculosis (TB) than from dengue and HIV-related complications.

There were 1,945 TB deaths from 25,739 cases last year, a 14.7% increase over 1,696 deaths from 24,220 cases in 2015, according to the Health Ministry.

In comparison, there were 237 dengue fever deaths from 101,357 cases last year and 336 deaths from 120,836 cases in 2015.

Malaysian health authorities are now concerned because infectious diseases such as TB, leptospirosis and rabies, which the country managed to successfully curb in the past, are making a comeback, said former Institute of Respiratory Medicine director Datuk Dr Abdul Razak Muttalif.

TB is responsible for the most deaths among all infectious diseases reported in Malaysia, he added.

Malaysia managed to bring down TB cases from more than 30,000 in 1960 to fewer than 6,000 cases in the mid-1980s but Dr Abdul Razak said the cases gradually increased again from the mid-1990s.

It was initially fuelled by the increasing number of HIV cases (from weakened immune systems) and a little by migrant workers in the late 1990s, he said.

Dr Abdul Razak said one factor contributing to the high numbers currently was the delay in diagnosis and treatment, resulting in the disease spreading.

One reason for the late diagnosis could be traced to patients seeing doctors for coughs in clinics.
Without laboratory facilities, some doctors did not get a chest X-ray done to detect it early, he added.

Other groups could pick up TB because of risk factors such as those with diabetes and HIV, as well as prisoners, drug users and migrants. Dr Abdul Razak said Malaysia was detecting more cases also because more people were being screened.

Meanwhile, leptospirosis, commonly known as rat urine disease, remains a concern in Malaysia, as the number of cases has steadily increased from 2,268 in 2011 to 8,291 in 2015, although the figure dropped last year to 5,284. Statistics show that in 2011, 55 people died of the disease, 78 in 2015, and 52 last year.

Universiti Putra Malaysia professor of veterinary bacteriology Datuk Dr Abdul Rani Bahaman said it was not easy to diagnose leptospirosis as there were more than 40 serovars, or strains of Leptospira bacteria and more are expected to be discovered.

Leptospirosis could easily be misdiagnosed because its symptoms are similar to those of malaria, influenza and dengue. They include headache, diarrhoea, body ache, muscle pain and jaundice, which can cause it to be mistaken for these viral diseases, Dr Abdul Rani said.

However, those returning from jungle trips or recreational areas with high fever should be screened for leptospirosis and treated with antibiotics as a treatment or preventive measure before the infection becomes critical, he added.

Encouragingly, statistics showed that leprosy – which spreads through inhaled droplets of moisture – is on the decline. There were 206 new cases last year, compared to 210 in 2015. In 2012, there were 325 new cases.


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