
VARANASI: When the world would come together to observe World Tuberculosis (TB) Day on Saturday (March 24), the district health administration would be looking for ways to eliminate multi-drug resistant TB cases, in line with the slogan and theme of the day that calls for a world free of TB. While the task looks daunting with over 6,000 TB patients registered under various directly observed treatment short-course (DOTS) centres in the district, it has also emerged as a challenge for health authorities looking to curb TB cases in the region.
"We have already identified about 250 suspected resistant TB cases in the district that are going to be covered under DOTS Plus project. A number of these cases are also HIV positive, requiring special focus and attention under the project. The appraisal has been approved by the state government and after the appraisal of the Central government, it would be known as problematic management of resistant TB (PMRT) to specifically target resistant TB cases," said Dr UK Verma, district TB officer (DTO) while talking to TOI on Friday.
It may be mentioned here that a state-of-art anti-retroviral therapy (ART) centre has been running at Banaras Hindu University for detection and treatment of HIV positive cases. The centre has registered over 14,000 HIV positive cases in the last seven years with some of the cases also witnessing resistant TB to aggravate the conditions.
As per reports of district TB centre (DTC), about 6,500 TB patients are presently registered at various DOTS centres with nearly 250 suspected resistant TB cases. There are a total of seven TB units with as many as 43 microscopic and DOTS centres equipped with facilities of sputum examination for detection and treatment of TB cases under DOTS programme in the district. The programme ensures proper and regular medication lasting between six to nine months under the supervision of doctors for eliminating TB in the region.
According to Prof SC Matah, chest department (TB and respiratory diseases), BHU, (TB) is often not considered as a possible diagnosis and therefore goes undetected in children. This has made it difficult to assess the scope of the childhood TB epidemic. There is a need to come up with cheap and rapid tests that identifies TB in children who are at high risk. Similarly, a fully effective vaccine that protects children (and adults), including those living with HIV, against all forms of TB needs to be developed for creating a world free of TB. "But above all that, community knowledge and advocacy to create awareness about TB is needed to tackle the problem at grass root level," he added.
WHO consensus: Don’t use TDR-TB label
MUMBAI: It's not yet time to use the label of totally drug-resistant tuberculosis.
This is the consensus that emerged on Friday at the World Health Organization's (WHO) special meeting in Geneva to discuss a new nomenclature for the new, severely drug-resistant TB forms emerging in parts of the world.
The consensus, a day before World TB Day, also called for clinical trials of 'salvage drugs' (or compassionate drugs) which are a last-ditch therapy for patients now.
Hinduja Hospital reported 12 cases of TDR-TB in January, triggering a worldwide debate on whether the TB bacillus had become deadlier and immune to known drugs. The hospital's research team, led by Dr Zarir Udwadia, published a letter in the 'Clinical Infectious Diseases' journal highlighting the plight of four patients who were on salvage therapy after TB drugs failed. The media then reported eight other cases, three of whom died.
Dr Udwadia was invited to present his data at the WHO meeting, but the conclusion was categorical. "There is currently insufficient evidence to adopt new case definitions for drug-resistant TB,'' said the WHO press release.
Dr Udwadia told TOI on Friday that the very fact WHO has recognized that these new virtually untreatable types of TB exist is a step forward. "Changing terminology and introducing a new term from MDR and then XDR to now TDR is a hugely difficult undertaking and has great implications at programmatic levels across the globe,'' he said.
He added that many committee members felt, for various reasons--political and psycho-social--that TDR carried too many negative associations, was too final a descriptor, and carried a sense of hopelessness.