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With the dissertation ‘Tuberculosis in Suriname. Trends in epidemiology, diagnostics and treatment’, pulmonologist Fitzgerald Gopie obtained his doctorate from the Faculty of Medical Sciences of the ADeKUS on 10 November 2021.
Doctor Gopie received his training as a doctor at the Faculty of Medical Sciences, of which his internships were largely done at the Academic Hospital Paramaribo. From 1998 to 2001 he worked as a part-time/full-time A&E doctor at the emergency room of the AZP. In 2001 he started specializing in lung specialist in Suriname, which he successfully completed in 2007 at the Medisch Spectrum Twente in Enschede, the Netherlands. On 1 December 2007 he started working for the AZP as a lung specialist.
Between 2016 and 2020, 680 patients were diagnosed with tuberculosis in Suriname. On average 136 people per year. Of these patients, 141 had HIV co-infection and a total of 85 died from/with TB, of which 30 had HIV co-infection. Previously, Trio Indians in Kwamalasamutu (South Suriname) were diagnosed with disproportionate TB, possibly related to genetic factors, their lifestyle and limited access to health care. This fact in relation to the multi-ethnic population of Suriname has been the trigger for the research of Dr. gopy.
In his thesis the following aspects are discussed: the occurrence of tuberculosis among the various population groups and the related risk factors, the diagnosis of tuberculosis and the presence and treatment of drug-resistant tuberculosis in Suriname. In addition, the application of the Mantoux test/TST, used in the diagnosis of latent tuberculosis, has been evaluated.
The respiratory disease tuberculosis (TB), transmitted from person to person via droplet infection, belongs to the field of activity of the pulmonologist. Symptoms that may indicate tuberculosis are: prolonged cough, weight loss, fever and night sweats. TB patients are traditionally treated in a sanatorium. The lung pavilion of the AZP on Picornistraat has been home to the sanatorium since the 1950s. Patients diagnosed with tuberculosis are admitted there for treatment, diagnosis, monitoring of therapy and possible side effects of medication, as well as evaluation of patients’ social situation.
When a patient is no longer contagious and his home situation is acceptable, he is discharged from the sanatorium. On an outpatient basis, the patient is regularly seen by the pulmonologist and monitored by the National Tuberculosis Program (NTP) of the BOG. The NTP, as an arm of the Ministry of Health, provides, among other things, the free provision of tuberculosis medication, the national TB statistics and the contact investigation. This study is conducted among people who have been in close contact with TB patients. The purpose of this evaluation is to identify individuals with latent tuberculosis. It is checked who could be infected by a TB patient, but who do not show any symptoms.
In latent TB patients (if not treated) tuberculosis can become manifest due to, among other things, a reduction in immunity due to an HIV infection. Tuberculosis is a treatable disease from which the patient can be cured, if diagnosed in time and treated with the right medication. Therapy adherence to the patient is crucial, as the standard treatment is 6 months, with 4 different types of drugs. If a patient is not adherent, this can result in resistant TB bacteria, which is called drug resistant tuberculosis. The treatment of this form of tuberculosis takes much longer than 6 months, is done with much more expensive and more drugs, with a greater chance of side effects.
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