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Report: TB Cases Increase in Europe

March 24, 1998

COPENHAGEN, Denmark (AP) _ Tuberculosis is spreading across Europe, notably in Russia, due to crumbling health-care systems, political instability and a lack of commitment to curtail it, the World Health Organization warned Tuesday.

``Tuberculosis is uglier and more frightening than ever,″ Dr. Arata Kochi, head of the WHO’s Global TB Program, said at a news conference. ``It moves with people and doesn’t respect national boundaries.″

The situation worsened in 18 of the 26 countries in eastern Europe, where the number of tuberculosis cases rose by more than 25 percent from 1994 to 1996, the U.N. health agency said.

Western Europe is not immune. The daily arrival of immigrants who already have the disease has increased the number of cases even in countries that have well-functioning public health-care systems.

Romania had the highest TB rate in the region, with 107 cases per 100,000 inhabitants in 1996. Kyrgystan was next with 92 cases per 100,000 people. Seven Romanians die of tuberculosis each day and 70 more become infected, according to Dr. Ioan Stoicescu, a leading specialist at the Institute for Research of Lung Diseases in the Romanian capital, Bucharest.

Tuberculosis, which attacks mainly the lungs, can be cured with drug treatment for six to eight months. But WHO said poorly managed TB treatment programs are causing drug-resistant strains of tuberculosis to emerge.

Tuberculosis has become a bigger killer than malaria and AIDS combined, but experts complain that attention has shifted instead to more publicized diseases. There are 10 times more TB cases in Europe than there are AIDS cases, according to WHO data.

In Russia, TB rates doubled from 1990 to 1996, to 75 cases per 100,000 inhabitants, WHO said. In Karakalpakstan, an autonomous republic in northwestern Uzbekistan, the rate was 97 per 100,000.

Curtailing the disease is more difficult because Europe has the world’s highest level of combined resistance to four of the most effective anti-TB drugs.

U.N. and European health experts attribute the spread of the illness to poverty, malnutrition, poor living conditions, lack of drugs, and to the low priority post-communist governments have given their state-run health systems.

The collapse of the Soviet Union at the turn of the last decade, and the subsequent political instabilities in the region, also are to blame, said Joe E. Asvall, the head of the agency’s regional European headquarters in Copenhagen.

``In the Soviet Union, there were better vaccination programs and diphtheria and tuberculosis were under control,″ Asvall told reporters.

Norway and Sweden have the lowest TB rates in the world with 5 and 6 cases, respectively, per 100,000 inhabitants. The rate in Germany is 14.5 cases per 100,000 people.