Compared to developed countries, Quality of Chest disease management in Bangladesh is almost equal

What are the common Chest Diseases prevalent in Bangladesh?
What is the status of management of these diseases in our country? Common chest diseases prevalent in Bangladesh are pulmonary tuberculosis, Bronchial asthma, Respiratory tract infections, Pneumonia. Different seasonal viral infections and in children most prevalent respiratory disease are Bronchiolitis, Pneumonia, Bronchial asthma, Pulmonary tuberculosis, Viral respiratory tract infections.
Regarding status of management, all the above diseases are manageable at home, only a few percentage of patients need hospitalization. In our country, it is possible to manage all these diseases in all govt. and private hospitals. Only 1-2% patients need intensive care support (ICU). When patients need ICU support, only those cases need special hospital as all hospitals are not equipped with ICU.

As an eminent Chest Specialist of the country, how do you assess the facilities available in Bangladesh for treatment of Chest diseases?
Chest diseases are now a day’s increasing throughout the world and in Bangladesh it is also increasing. In govt. level, facilities are not adequate to meet the demand, especially when patient needs hospitalization and those who need ICU support. Treatment as outdoor patients in govt. hospitals is sufficient, but it is not possible to supply medicines to patients in all hospitals, regarding investigation for chest diseases all hospitals are not well equipped equally to meet the demand of patients. In all the private hospitals, there are facilities to get treatment for respiratory diseases, but all are not equally wellequipped to serve the patients and most of the private hospitals have no ICU and the cost are not affordable by majority of patients.

Would you please tell us about the prevalence of Asthma in Bangladesh and its management?
On behalf of Bangladesh Lung Foundation, we, a few respiratory physicians conducted a survey throughout the country in 1999 and in 2009, to see the prevalence of Asthma in our country and we found that asthma prevalence in1999 was 7.5% and in 2009 it was 8.5%. So, it showed that it is increasing gradually.
Regarding management of Asthma, Asthma management has three components
a) Education
b) Caution
c) Treatment

Education: All the asthmatic patients should know what is asthma, why it happens, what are the triggers, when the patient will seek for medical advice, when he will go for admission, how he will manage emergency at home, what is preventive and reliever medicines, what is peak flow meter and how it is helpful for asthma, what is spacer and nebulizer and their rational use etc.

Caution: All the asthmatic patients should know what caution they will take to avoid asthma attack. Should avoid pats in house, preferably should not use carpet and blanket, should avoid cold and dust, if able to identify any food provoking attack and should avoid it 

Treatment: All patients should be treated as per standard guideline that is Step Care Management. Patients should be given appropriate step of management, if not improved step to be made, if there is improvement then step down to be done. Every time patient should be monitored whether he is taking drugs properly and taking appropriate medicines or not.

Do you think Bangladesh has all the state-of-the-art facilities to diagnose Chest disease ailment? Do the common people have access to such facilities?
Almost all the modern facilities to diagnose chest diseases are available in Bangladesh, but not in a single center. These facilities are a bit expensive, not within the reach of common people, as some investigations are expensive throughout the world.

Where do we stand as far as the quality of Chest diseases management in Bangladesh compared to developed countries?
Compared to developed countries, quality of chest disease management is almost equal, but where patient needs advanced intervention for lack of instrument, it may not be possible sometimes but regarding principle of management quality is the same.

As the management of TB has become a little bit complicated due to its being resistant to drugs, what is your advice to address this new phenomenon?
Drug resistant TB is a global problem. It is a challenging problem for us, because we have no separate hospitals and separate manpower for this. So, to combat this, it is urgently needed to establish a separate hospital and trained manpower and supply of drugs for resistance of TB. Drug resistant TB needs special attention on priority basis as it is almost harmful like AIDS.

Do you think that our pharma industries are capable to meet our local demand with quality products for Chest diseases? Our pharma industry is not only capable to meet our demand with quality products, but many respect, they are superior to our neighbouring countries.