Although the burden of tuberculosis in the WHO European Region is among the lowest in the world, in Ukraine the disease continues to be a major public health challenge.
Dr Oksana Moloda, a tuberculosis (TB) specialist from the Ukrainian city of Odessa, says this is primarily due to the spread of myths around TB. Health workers have a very important role not only in treating TB patients, but also in addressing the spread of misinformation and ensuring patients understand what is best for them.
“I will never forget a case from my early years as a TB specialist. Ukraine had just started implementing modern clinical approaches,” Oksana shares.
“My new patient, a young man in his early twenties, was underweight and depressed. His lungs had been destroyed by TB – I simply couldn’t see healthy tissue. This young man had become resistant to most available drugs and was not willing to receive any treatment.”
Oksana made it her mission to work closely with him, convincing him of the right therapy to take, tailored specifically to his condition.
“He recovered, gained more than 40 kilos, and survived surgery. I was finally able to see him in good health and spirits,” she recalls. “Tuberculosis is a challenging disease and working in this field isn’t easy. Rewarding experiences like these remind me why I chose to become a phthisiologist.”
Stigma and misinformation still the main challenges
Oksana says that misinformation around TB is not limited to patients such as the one she encountered early in her career. Many health workers themselves continue to harbour misconceptions about the disease.
“Sadly, stigma persists. Even among us health-care workers. Many still believe that TB patients require long periods of isolation from society,” explains Oksana. “But with the right therapy, a patient may only need to be hospitalized for a couple of weeks.”
“When patients stay in hospital longer than required, they are less able to fend off the disease on their own,” Oksana says. This, in turn, takes a toll on their mental health, making treatment even harder to achieve.
“This stigma ends up discouraging patients from seeking further help, and we need to do something about it. How? By educating everyone, including our colleagues in the medical field.”
Ending TB in the time of COVID-19
Provisional data compiled by WHO from 84 countries indicates that an estimated 1.4 million fewer people received care for TB in 2020 than in 2019 – a reduction of 21% from 2019. WHO estimates that these disruptions in access to TB care related to COVID-19 could cause an additional half a million TB deaths.
Timely diagnosis is key to a quick recovery, and with expertise and advice from WHO, Ukraine is stepping up to improve TB diagnosis.
“COVID-19 and TB make for a very complicated combination, because patients with tuberculosis often have complications when infected with the coronavirus,” Oksana explains. “At the same time, with the pandemic we have seen better diagnostics, simply thanks to patients opting for CT scans more often than before.”
The year 2021 has been designated as the International Year of Health and Care Workers in appreciation of and gratitude for their unwavering dedication in the fight against the COVID-19 pandemic.
This story has been developed by the WHO Country Office in Ukraine, with financial assistance from the European Union, and is part of a series of stories showcasing Ukrainian health-care workers.