Tuberculosis: stigma is fading but the threat remains

Tuberculosis has always been considered a shameful disease. And hiding the infection encouraged contagion. After the Second World War, patients were locked up in rudimentary wooden huts outside Romainiai Hospital, in the suburbs of Kaunas, Lithuania.

Today, although the stigma is fading, the disease still frightens people. "In the past, if you had a tuberculosis patient in your family, or even if it was yourself, you were always afraid that someone would find out," explains Skaidrius Miliauskas, head of the pneumology department at the Lithuanian University of Health Sciences Hospital in Kaunas. But today, anyone can contract tuberculosis. Like us, there are lawyers, doctors, engineers, scientists. It's not as much of a taboo as it used to be, but some patients still ask: "Do everything you can, so that no one knows I had tuberculosis."

If tuberculosis is a source of stigma or shame, it's because it mainly affects disadvantaged populations. People living in closed or overcrowded environments, such as prisons, homeless shelters, are more exposed. Drug use and incarceration are associated with latent tuberculosis infection.

Nearly a third of the world's population is infected with tuberculosis.

"We call this latent tuberculosis infection," says Professor Miliauskas, "but only a small number of them will develop the disease, because the mycobacteria remain in your body and wait for you to be immunocompromised, as in the case of HIV, or to be on medication, such as antitumor drugs, or even necrotic factors, which can be problematic."

According to a report by the WHO, "the disease disproportionately affects populations in 30 countries with a high disease burden, with ’India (26%), Indonesia (10%), China (6.8%), the Philippines (6.8%) and Pakistan (6.3%) together accounting for 56% of the global TB burden." "55% of those who developed the disease were men, 33% were women, and 12% were children or young teenagers."