posted
Something to be thought about next time you are visiting a shisha place....
EGYPT: Water pipe smoking a significant TB risk
24 Mar 2008 16:34:56 GMT
Source: IRIN
Reuters and AlertNet are not responsible for the content of this article or for any external internet sites. The views expressed are the author's alone.
CAIRO, 24 March 2008 (IRIN) - The smoking of the traditional 'shisha' water pipe is increasingly emerging as a significant health risk in Egypt, due to air-borne tuberculosis (TB) transmission from pipe sharing and uncontrolled, manual preparation of the pipe.
Rania Siam, professor of microbiology at the American University in Cairo (AUC), said the most important risk factor for TB infection was close household contact with a TB case, but she said water pipe smoking (WPS) and the sharing of the pipe with someone with pulmonary TB led to a great risk of TB transmission, especially among young adolescents.
"'Shisha' [smoking] is Egyptian culture, where people smoke tobacco and inhale directly from this device. If I smoke 'shisha', some bacteria may reside in it. When you go to a fancy bar, they do change the mouthpiece, but what about the tube of the pipe? And the water? You still have water in the container where the bacteria resides," she said.
The World Health Organization (WHO) regional office in Cairo estimates that 17 percent of TB cases in the eastern Mediterranean are attributable to the smoking of water pipes.
According to the latest WHO statistics for Egypt, 31.6 in every 100,000 people had TB in 2005, and the rate of new TB cases that year was estimated at 25 per 100,000 people.
The WHO regional office said lack of TB control initiatives led to inadequate health care behaviour, affecting patients' diagnoses and treatment, and it therefore called for new public health care strategies.
Health Ministry statistics
Essam Moghazy, manager of the National Tuberculosis Control Programme (NTCP) at the Egyptian Ministry of Health, said the country's current case detection rate was 70 percent and that the treatment success rate was 87 percent. He said there were now lower rates of treatment interruptions among patients.
In contrast, Akihiro Seita, TB adviser at the WHO regional office, said the non-compliance of patients with, and non-adherence of physicians to, the recommended treatment regimens constituted a major challenge that sustained TB transmission.
WHO's Stop TB Strategy was launched in Egypt in 2006. The strategy focuses on DOTS (Directly Observed Treatment Short Course). This consists of six key components: political commitment with increased and sustainable financing; case detection through quality assured bacteriology; standardised treatment, with supervision and patient support; an effective drug supply and management system; monitoring and evaluation; and impact measurement.
NGO involvement
The NTCP is working with several NGOs to raise public awareness about TB, especially through TV and radio advertisements.
"We try to involve all health care providers, NGOs, health insurance organisations, prisons. In some sectors the collaboration is good and in some sectors it's bad. But with orientation meetings and workshops we hope to improve collaboration," the NTCP's Moghazy said.
But according to the WHO's Seita, there is only a limited contribution by NGOs and community-based organisations, leading to "low awareness in the community about the disease and inadequate health care behaviour".
One example of NGO involvement is Save the Children Egypt, which refers suspected cases to the country's Health Insurance Organisation for diagnosis and medical treatment, but does not run its own TB programme.
New strains
According to Amal Hussein of the Save the Children office in Minya, a major challenge is that in the last couple of years a new strain of the TB mycobacterium began to appear in Egypt. It causes enlargement of the intestal organs, stomach, lymphnode and abdomen to which the standard antibiotic treatment does not respond.
The AUC's Rania Siam said: "Every newborn child in Egypt gets Bacille Calmette Guerin (BCG) vaccine to protect it against TB. The emerging TB strains are now resistant to this vaccine, and to antibacterium available on the market. The problem is that the bacterium is mutating to survive."
There is a need for the development of new vaccine types and drugs to prevent infection from the emerging bacteria strains. "Lots of research is going on at the moment... in order to identify the prevalent strains and to find appropriate vaccines to fight the new strains," Siam said.
Curbing WPS
According to a 2005 article by the American Academy of Pediatrics, public health strategies for controlling WPS should focus on the implementation of new laws to limit the acquisition and use of water pipes, and better health education targeting adolescent smokers.
The WHO is currently implementing a Tobacco Free Initiative (TFI) in Egypt, to reduce WPS through tougher legislation and smoking cessation interventions.
In order to limit air borne TB transmission, Siam recommends that people either stop smoking the pipe completely or bring their own 'shishas' to the bars to minimise health hazards. But Yahia Ali, an AUC mechanical engineering student, said the size of the 'shisha' meant such an initiative was impracticable.
posted
my dad says they used to call hookah "TB" as a slang in Pakistan.
I doubt theres much risk for contracting TB in the US though.
EgyptxFirst Member # 14776
posted
shisha only gives u a head ache any way :/
Tigerlily Member # 3567
posted
quote:Originally posted by hibbah: I doubt theres much risk for contracting TB in the US though.
Because TB is under control in the US!!
Btw, I have been vaccinated against TB a few times in the past.
Tigerlily Member # 3567
posted
quote:Originally posted by EgyptxFirst: shisha only gives u a head ache any way :/
Heehee, when you move back Egypt you better get used to smoking the pipe because all the men there are doing it, some more some less. Just a joke, you are doing great in staying away from shishas which are very harmful to your health not only because of possible exposure to TB.
I assume you don't smoke cigs either - which is a great thing. Don't ever become a victim!
EgyptxFirst Member # 14776
posted
HECK NO! i only smoke shisha like 2 times a year lol. no cigs never
yorkshire rose Member # 12072
posted
Iff you have had the vaccination are you covered for life or you think you could get it from smoking shisha. BTW i dont smoke it, just a question?
With a name like Smuckers Member # 10289
posted
I never thought I would end up married to a guy so straight that he never even tried sheesha or cigarettes much less alcohol or drugs. I'm happy to say he abhors such things, but after reading this even more so.
BTW you know those little juice shops where they sell the fruit drinks and STICK DRINKS (as I call them)? I always wonder about the TB (and hepatitis) risk as I'm sure they hardly wash the glasses EVERYONE uses...they probably just run the glasses under cold water a minute or two to rinse them and then reuse them. YUK. We never drink at those places either unless we use our own cups. (yes we ask to have him fill our OWN cups, but he tries to pour it in a glass first to measure, so beware if you try this, just tell him to please not do that and if he has to give us less than normal that's ok). You don't have to explain more than that.
Tigerlily Member # 3567
posted
Yorkie, the article states that shisha smokers are at risk.
BTW as far as I know there is no vaccination out for adults.
Transmission of TB:
"Further information: Transmission (medicine) When people suffering from active pulmonary TB cough, sneeze, speak, kiss, or spit, they expel infectious aerosol droplets 0.5 to 5 µm in diameter. A single sneeze, for instance, can release up to 40,000 droplets.[17] Each one of these droplets may transmit the disease, since the infectious dose of tuberculosis is very low and the inhalation of just a single bacterium can cause a new infection.[18]..."
Treatment for Tuberculosis (TB) Treatment for TB was only available from about 50 years ago. Active tuberculosis, if not treated, will infect on average between 10 and 15 people every year. If active tuberculosis is not treated it can kill and treatment currently reaches only about a quarter of people with Tuberculosis.
Antibiotics are used in the treatment of Tuberculosis (TB). Antibiotic treatment therapy is lengthy and you have to take them for six to 12 months to completely destroy the bacteria. The length of treatment and the type of drug that is needed is determined by your age, overall health, the results of susceptibility tests, and whether you have TB infection or active TB.
It is the length of drug treatment that causes so many difficulties in developing countries as well as in the West. Poor supervision, incomplete treatment, doctors and health workers prescribing the wrong treatment regimens, or an unreliable drug supply not only fails to treat TB but can lead drug-resistant TB.
Surgery is now very rarely used to treat TB.
????? Member # 12336
posted
quote:Originally posted by Tigerlily: Yorkie, the article states that shisha smokers are at risk.
BTW as far as I know there is no vaccination out for adults.
Transmission of TB:
"Further information: Transmission (medicine) When people suffering from active pulmonary TB cough, sneeze, speak, kiss, or spit, they expel infectious aerosol droplets 0.5 to 5 µm in diameter. A single sneeze, for instance, can release up to 40,000 droplets.[17] Each one of these droplets may transmit the disease, since the infectious dose of tuberculosis is very low and the inhalation of just a single bacterium can cause a new infection.[18]..."
When people are starting to work in healthcare they get a test: Mantoux. When the result is negative, they get injected with Bacillus Calmette-Guérin (BCG) , and that gives protection against TB. This is how it is told to me, many many years ago. Probably will be outdated ...
Tigerlily Member # 3567
posted
Last year a man was detained in the US with TB
posted ![[Wink]](wink.gif)
![[Confused]](confused.gif)