Diseases of Poverty: Part 2

Bacterial Infections

As one of the leading causes of death worldwide, Tuberculosis continues to be a problematic infection for populations living in poverty. Most common in Sub-Saharan Africa, tuberculosis places a large burden on people of low-income families. One study found that patients that are illiterate are twice as likely to contract Tuberculosis, indicating that the socioeconomic status of patients places them at high risk for infection (Shimeles, 2019). In addition, patients with a fellow household resident with Tuberculosis are three times as likely to contract the infection, placing patients at risk who live in highly populated homes. As tuberculosis is an airborne infection, one can imagine that highly populated areas with many family members in one home increases a person’s risk significantly. The same study showed that patients who lived in homes with one or fewer windows in the house were twice as likely to contract Tuberculosis (Shimeles, 2019). Notably, the World Health Organization set forth their End TB Strategy in 2015 with a 20 year timeline with the underlying goal to break the trend of accepting marginal success in managing global disease. Their plan includes reducing the incidence of tuberculosis by 90%, reducing deaths by 95%, and ensuring that the financial burden of treating tuberculosis does not overwhelm those affected by it (TBFacts.org, 2019).

Haemophilus influenza and Strep pneumonia are two additional bacterial infections that ravage communities of low socioeconomic status, especially those that do not have access to the H. influenza vaccination. One study seeks to analyze the association with pneumonia and these socioeconomic/environmental factors in children (Thörn, 2011). Because the diagnosis of pneumonia is mostly a clinical based diagnosis, the criteria for patients to be diagnosed included high clinical suspicion and a positive chest X-ray. While it is not possible to definitively have diagnosed these children with bacterial pneumonia without an alveolar aspirate, it is suspected that in most areas in developing countries bacteria are primarily responsible for causing pneumonia in children (Thörn, 2011). The study found a correlation between low socioeconomic communities and rates of pneumonia, stating that there is an 80% increase in prevalence of pneumonia in children living in poverty communities. In addition to higher rates, the study also found higher rates of mortalities/worse outcomes in patients living in impoverished communities. The article states that the higher prevalence is likely due to more crowded households and underlying diseases, such as malnutrition (Thörn, 2011). However, the worse outcomes are likely due to less access to healthcare. Worldwide, the implementation of Streptococcus pneumonia vaccination has significantly reduced the burden of the infection on the population. However, at the time of this study and still currently, the vaccination is still not as widespread throughout developing countries. Thus, in communities experiencing poverty, Streptococcus pneumonia continues to burden children.