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IFGH: No more TB suspects: changing the way we talk about tuberculosis   2012-05-17 12:36:00 <globalhealth@...>
IFGH: No more TB suspects: changing the way we talk about tuberculosis

Dear friends,

The following press release discusses TB terminology and may be of interest to some
of you:

15 May 2012 / Paris, France

The words ‘defaulter’, ‘suspect’ and ‘control’ have been part of the language of
tuberculosis (TB) services for many decades, and they continue to be used in
international guidelines and published literature.

The detrimental effect of such negative language is detailed by TB experts from
around the world in an article in the June issue of the International Journal of
Tuberculosis and Lung Disease, “Language in tuberculosis services: can we change to
patient-centred terminology and stop the paradigm of blaming the patients?”

The authors describe how judgmental terms, such as referring to a person who might
have tuberculosis as a ‘TB suspect’ can powerfully influence attitudes and
behaviour at every level – from inhibiting patients to seek treatment to shaping
the way policy-makers view the challenge of addressing the disease. They call for
the Stop TB Partnership to lead discussions on this issue and make a change.

“From a patient perspective, these terms are at best inappropriate, coercive and
disempowering”, says lead author Dr Rony Zachariah of Médecins Sans Frontières. “At
worst, they could be perceived as judgmental and criminalising”.

The article also observes that the powerfully negative connotation of words such as
‘defaulter’ and ‘suspect’ tend to place blame for the disease and/or responsibility
for adverse treatment outcomes on one side — that of the patients.

Bringing together the opinions of authors and institutions from Africa, Asia, Latin
America, Europe and the Pacific, the article proposes that the current terms be
replaced with non-judgmental and patient-centred terms.

For example, the term ‘TB suspect’ could be replaced by ‘person with presumptive
TB’ or ‘person to be evaluated for TB’; and a ‘defaulter’ could be referred to
instead as a ‘person lost to follow-up’.

And finally, that term ‘control’, which is not used in reference to other equally
problematic infectious diseases: it could be replaced with the more appropriately
descriptive ‘prevention and care’ or simply deleted.

The Stop TB Partnership and the World Health Organization have both responded
positively to this call to action as needed to build on the Patients’ Charter for
Tuberculosis Care, published in 2006, as well as the goals outlined in the Global
Plan to Stop TB 2011–2015.

The same IJTLD issue includes an editorial by the Stop TB’s Executive Secretary Dr
Lucica Ditiu and the Vice Chair of the Partnership’s Coordinating Board Blessina
Kumar. “Tuberculosis care: why the words matter” describes the article as
crystallising a long-standing problem and strongly agrees that language has “the
power to transform how people think and behave”.

The World Health Organization also commented that they are working on recommended
definitions of TB cases and treatment outcomes, and that the authors’ input will be
considered in that process. Their final recommendations are expected by the end of

Click here to read the article:

Click here to read the editorial:


IFGH members, what do you think of this call to change? Let us know your thoughts.

Kind regards,

The Irish Forum for Global Health

Irish Forum for Global Health -

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