In Lithuania, the number of people suffering from tuberculosis is among the highest in the European Union. Kaunas’ hospital has been modernised thanks to European funding and is aiming to curb the disease thanks in part to a new genetic test that can diagnose the disease in just four hours.
Tuberculosis is one of the most deadly diseases, affecting almost 11 million people worldwide. Lithuania is one of the worst affected countries in Europe, with 23 cases per 100,000 inhabitants, compared with just seven cases in France. This high rate is due to the collapse of health structures which allowed tuberculosis to spread following the fall of the Soviet Union. In 1998, there were 87 cases per 100,000 inhabitants. Since then, the country of less than three million people has been trying to return to values closer to those of Western Europe.
To curb the disease, the European Union has invested in renovating the Romainiai hospital in Kaunas, the country's second largest city. The establishment is part of the Kauno klinikos, the largest hospital centre in the Baltic States.
The Romainiai hospital has been treating tuberculosis patients since 1937. At the height of the endemic, there were 500 beds here. Today, 150 remain, most of them occupied by tuberculosis patients.
From 2016 to 2020, the old premises were renovated: four years of work totalling more than €13 million, 85% of which funded by the European Union's cohesion policy.
The results are modern rooms and cutting-edge equipment. The hospital now has fibrescopes to perform bronchoscopies, the examination of the bronchial tubes that is essential for diagnosing tuberculosis.
The hospital has also digitised its x-ray room, with images digitised and stored in a database that can be consulted by doctors across the country. But the most revolutionary advance is a genetic test capable of making a diagnosis in just 4 hours, while also detecting drug resistance. The samples come from all over Lithuania.
This allows the treatment to be implemented as quickly as possible.
Treating the disease is a long-term battle. Especially if the patient is resistant to the standard treatment for tuberculosis, Rifampicin, or to other drugs. In the case of multi-drug-resistant tuberculosis, treatment can last up to two years, instead of six months.
One of the biggest challenges posed by tuberculosis is that it is difficult to spot. Dr Greta Musteikiene explains that the symptoms are coughing, fever, weight loss and fatigue.
Alma has been in hospital here for six months. Her treatment could last 18 months. With a bit of luck, she’ll finish it at home. The first few days in this hospital, 100 km from her home, were very difficult.
She was worried about the stigma of those around her. Her work colleagues were kind, but they were tested. Alma won't be going back to her old job, where she sorted vegetables in the cold - she can’t tolerate low temperatures any more.
Tuberculosis is a disease that you can contract and never develop. Of the two billion people infected worldwide, only 5% are ill. The disease particularly affects the most disadvantaged sections of the population and alcoholics. But anyone can be affected if they come into contact with someone with tuberculosis who is coughing.
The Kaunas hospital is continuing its fight to bring tuberculosis rates down. In 60 years, the number of patients in Lithuania has fallen by 90%.