Health officials said Wednesday that more than 200 people on Majuro and about 300 more on Ebeye have been identified as having had contact with patients suffering from drug-resistant TB, a difficult- and costly-to-treat mutation of regular tuberculosis.
Health officials say it costs $174,000 for the drugs to treat one case of multidrug-resistant, or MDR, strain of TB, and persons having come into contact with infected persons must be put on prophylactic doses of drugs to prevent spread.
The Marshall Islands already had the Pacific’s highest rate of TB when new cases of drug-resistant TB were discovered in November, elevating the threat. The Marshall Islands has a rate of 198 TB cases per 100,000 residents, while, according to the U.S. Centers for Disease Control, the U.S. national rate is currently held to 4 persons infected per 100,000. Hawaii has the highest rate in the U.S. at 9.6 cases per 100,000.
Ten people have been diagnosed with and suffer from multidrug-resistant TB in the Marshall Islands at the present time, said Majuro Hospital administrator Dr. Marie Lanwi-Paul.
Locally generated MDR-TB cases result when people stop taking their medications before the nine-month duration required for successful treatment ends, allowing their TB to become resistant to regular TB drugs.
“We have begun the process of procuring enough second-line drugs to treat the 10 identified MDR-TB cases,” Lanwi-Paul said. “We will also procure additional drugs to treat the estimated 200-plus MDR-TB contacts in Majuro that have recently been identified.”
A U.S. Centers for Disease Control consultant was in Majuro recently to assist the Ministry of Health with its TB control program, she said Wednesday.
“Contact tracing is continuing as we speak,” she added.
Lanwi-Paul said Majuro Hospital’s TB isolation ward can accommodate eight patients, “but we are in the process of increasing that area to double the bed capacity. It’s still too early to tell how many will need to be isolated for MDR-TB.”
But late last week, TB program head Dr. Kennar Briand spoke about TB in a national broadcast on the government-run AM radio station, stating that “many patients are stubborn” about accepting TB treatment and either run away from nurses when they come to their homes to deliver medicine or move to other islands, complicating treatment and leading to the drug-resistant TB strains now found in the country.
