2007年VOA标准英语-Rising Numbers of TB Victims, Emergence of Drug

By Scott Bobb
Johannesburg
19 March 2007

 
 
Tuberculosis¹ until a few years ago was off the informal list of priority diseases because it could be prevented and it could be cured. Now, as the world marks Tuberculosis Day, the disease is causing alarm because of the rising numbers of cases and the emergence² of strains of TB that are resistant³ to almost all known drugs. Correspondent Scott Bobb in Johannesburg visited Sizwe Hospital, one of South Africa's largest facilities for people with drug-resistant TB, and has this report.

Sizwe Tropical Diseases Hospital is a rambling⁴ group of one-story buildings lying on the outskirts⁵ of Johannesburg.

The pastoral site, which is also home to monkeys and wild birds, is an ideal location for the 260-bed facility which now cares exclusively for South Africa's growing population of people with drug-resistant Tuberculosis.

People with multiple drug-resistant TB have only a 50 percent chance of being cured. Three thousand new cases of MDR-TB were identified last year alone. And few people survive a new strain, called Extreme-Drug-Resistant TB, or XDR-TB, which is resistant to virtually every drug known to science.

Chief Medical Officer, Alicja Dziewiecki, says people develop drug-resistant TB when they abandon treatment before they are cured or when they receive incorrect doses of medicine.

"Multi-Drug Resistant TB, it is TB which is a man-made disease," said Dziewiecki. "This is our fault, patients' fault. All together we made this disease."

Patients take one painful injection and as many as two-dozen pills each day.

Treatment can take up to two years and the drugs have debilitating⁶ side-effects.

In Africa, more than three million people are living with TB. And half-a-million die each year from the microscopic⁷ (TB) bacteria which are spread through the air, usually by the cough of an infected person.

The number of TB victims is rising rapidly in Africa, due in large part to HIV/AIDS which weakens the person's ability to fight disease.

Children, too, are victims of drug-resistant TB. Most of the two dozen children at Sizwe Hospital are also HIV positive and most are orphans⁸. Some have families but have been rejected by them. If they are cured of TB, they will be placed in special homes.

Johannesburg's National Health Laboratory is located in an old but immaculate building in the center of town. It is one of the few public institutions that tests for drug-resistant TB.

Technicians here each day test 500 specimens⁹ from all over southern Africa. Because the TB bacterium¹⁰ is elusive¹¹ the specimens must be tested in several ways using smears¹² and cultures which are incubated for weeks.

Nearly one-fourth turn out to be drug-resistant and require even more testing to find out which drugs they resist.

 
An 8-month-old child outside the Church of Scotland Hospital in Tugela Ferry, where a killer¹³ strain of drug resistant TB has been discovered (File photo - 6 Sept 2006)
 
Lab director, Dr. Xoliswa Poswa, says during this time the victim may be infecting others.

"Waiting for two weeks, even more than two weeks in certain cases, is too long for someone who is quite ill," she said. "So for laboratorians it [the challenge] is coming up with diagnostic measures that are going to give them [doctors] a diagnosis¹⁴ upon which they can act quickly and save lives."

The laboratory is now experimenting with DNA¹⁵ tests which identify drug-resistance within two days.

Patients under treatment are separated from their families, sometimes for years. This causes economic and social problems for the patient and the family and requires extensive counseling for all.

Some health workers believe people with drug-resistant TB should be quarantined, even against their will if necessary, in order to protect their communities. But human rights activists¹⁶ say this would be a violation¹⁷ of their rights.

In South Africa, where memories of the abuses of the apartheid era are still fresh, the debate evokes¹⁸ strong emotions.

Sizwe's Head Doctor, Xavier Padanilam, notes that such issues are still unresolved because drug-resistant TB is so new.

"Regarding the moral, ethical¹⁹ issues, I would say we are still working on it," said Padanilam. "We haven't reached clear cut guidelines regarding forced isolation²⁰ of the XDR patient, how we can discharge those patients back to the community, those issues have to be worked out."

But he notes that most patients after counseling accept treatment and quarantine.

"Early on we treated the sensitive TB, and I used to meet patients in the townships, the cured patients," said nurse Alma Joyce Kutwane, who has been working with TB patients for 34 years. "But today the patients that I see that I cured are very few. I don't know whether it is because of the Multi-Drug Resistance or because of the HIV, I don't know. It really hurts. I feel like crying."

It has been more than 20 years since a new TB drug was developed. Some new drugs are now undergoing preliminary human trials but it will be years before they become available.

In the meantime, TB care givers say the most important way to confront the disease is to help the patient complete the treatment and deal with the months of separation from family and friends. For some with drug-resistant TB the separation will last the rest of their lives.

1 tuberculosis   

n.结核病，肺结核

参考例句：

• People used to go to special health spring to recover from tuberculosis.人们常去温泉疗养胜地治疗肺结核。
• Tuberculosis is a curable disease.肺结核是一种可治愈的病。

2 emergence   

n.浮现，显现，出现，（植物）突出体

参考例句：

• The last decade saw the emergence of a dynamic economy.最近10年见证了经济增长的姿态。
• Language emerges and develops with the emergence and development of society.语言是随着社会的产生而产生，随着社会的发展而发展的。

3 resistant   

adj.(to)抵抗的，有抵抗力的

参考例句：

• Many pests are resistant to the insecticide.许多害虫对这种杀虫剂有抵抗力。
• They imposed their government by force on the resistant population.他们以武力把自己的统治强加在持反抗态度的人民头上。

4 rambling   

adj.[建]凌乱的，杂乱的

参考例句：

• We spent the summer rambling in Ireland. 我们花了一个夏天漫游爱尔兰。
• It was easy to get lost in the rambling house. 在布局凌乱的大房子里容易迷路。

5 outskirts   

n.郊外，郊区

参考例句：

• Our car broke down on the outskirts of the city.我们的汽车在市郊出了故障。
• They mostly live on the outskirts of a town.他们大多住在近郊。

6 debilitating   

a.使衰弱的

参考例句：

• The debilitating disease made him too weak to work. 这个令他衰弱的病，使他弱到没有办法工作。
• You may soon leave one debilitating condition or relationship forever. 你即将永远地和这段霉运说拜拜了。

7 microscopic   

adj.微小的，细微的，极小的，显微的

参考例句：

• It's impossible to read his microscopic handwriting.不可能看清他那极小的书写字迹。
• A plant's lungs are the microscopic pores in its leaves.植物的肺就是其叶片上微细的气孔。

8 orphans   

孤儿( orphan的名词复数 )

参考例句：

• The poor orphans were kept on short commons. 贫苦的孤儿们吃不饱饭。
• Their uncle was declared guardian to the orphans. 这些孤儿的叔父成为他们的监护人。

9 specimens   

n.样品( specimen的名词复数 )；范例；（化验的）抽样；某种类型的人

参考例句：

• Astronauts have brought back specimens of rock from the moon. 宇航员从月球带回了岩石标本。
• The traveler brought back some specimens of the rocks from the mountains. 那位旅行者从山上带回了一些岩石标本。 来自《简明英汉词典》

10 bacterium   

n.(pl.)bacteria 细菌

参考例句：

• The bacterium possibly goes in the human body by the mouth.细菌可能通过口进入人体。
• A bacterium is identified as the cause for his duodenal ulcer.一种细菌被断定为造成他十二指肠溃疡的根源。

11 elusive   

adj.难以表达(捉摸)的；令人困惑的；逃避的

参考例句：

• Try to catch the elusive charm of the original in translation.翻译时设法把握住原文中难以捉摸的风韵。
• Interpol have searched all the corners of the earth for the elusive hijackers.国际刑警组织已在世界各地搜查在逃的飞机劫持者。

12 smears   

污迹( smear的名词复数 )； 污斑； （显微镜的）涂片； 诽谤

参考例句：

• His evidence was a blend of smears, half truths and downright lies. 他的证词里掺杂着诽谤、部份的事实和彻头彻尾的谎言。
• Anything written with a soft pencil smears easily. 用软铅笔写成的东西容易污成一片。

13 killer   

n.杀人者，杀人犯，杀手，屠杀者

参考例句：

• Heart attacks have become Britain's No.1 killer disease.心脏病已成为英国的头号致命疾病。
• The bulk of the evidence points to him as her killer.大量证据证明是他杀死她的。

14 diagnosis   

n.诊断，诊断结果，调查分析，判断

参考例句：

• His symptoms gave no obvious pointer to a possible diagnosis.他的症状无法作出明确的诊断。
• The engineer made a complete diagnosis of the bridge's collapse.工程师对桥的倒塌做一次彻底的调查分析。

15 DNA   

(缩)deoxyribonucleic acid 脱氧核糖核酸

参考例句：

• DNA is stored in the nucleus of a cell.脱氧核糖核酸储存于细胞的细胞核里。
• Gene mutations are alterations in the DNA code.基因突变是指DNA密码的改变。

16 activists   

n.（政治活动的）积极分子，活动家( activist的名词复数 )

参考例句：

• His research work was attacked by animal rights activists . 他的研究受到了动物权益维护者的抨击。
• Party activists with lower middle class pedigrees are numerous. 党的激进分子中有很多出身于中产阶级下层。 来自《简明英汉词典》

17 violation   

n.违反(行为)，违背(行为)，侵犯

参考例句：

• He roared that was a violation of the rules.他大声说，那是违反规则的。
• He was fined 200 dollars for violation of traffic regulation.他因违反交通规则被罚款200美元。

18 evokes   

产生，引起，唤起( evoke的第三人称单数 )

参考例句：

• The film evokes chilling reminders of the war. 这部电影使人们回忆起战争的可怕场景。
• Each type evokes antibodies which protect against the homologous. 每一种类型都能产生抗同种病毒的抗体。

19 ethical   

adj.伦理的，道德的，合乎道德的

参考例句：

• It is necessary to get the youth to have a high ethical concept.必须使青年具有高度的道德观念。
• It was a debate which aroused fervent ethical arguments.那是一场引发强烈的伦理道德争论的辩论。

20 isolation   

n.隔离，孤立，分解，分离

参考例句：

• The millionaire lived in complete isolation from the outside world.这位富翁过着与世隔绝的生活。
• He retired and lived in relative isolation.他退休后，生活比较孤寂。