GGRB28H3 Chapter 8: Chapter 8
Document Summary
Lessons from rural health y we know most things about it, but tb still kills more people than any other pathogen, far more than alcoholism, aids, malaria, tropical diseases and ebola combined, and nobody seems to care. Such explanations are contested terrain, and the literature contains striking divergences of opinion. Although patient noncompliance: generally heads the list of favored explanations, the vast majority of tuberculosis deaths are registered in settings of great poverty with abysmal tuberculosis services. In such venues, noncompliance is often outweighed by massive numbers of drop-outs from treatment, the results in no small part of prohibitively high treatment costs. Visitors to programs in such settings also report substandard care, a failure to keep accurate records, a near-total lack of follow-up, and high mortality. One review noted that the proportion of patients with active disease who complete therapy under standard conditions ranges from as little as 20-40 percent in developing countries.
