Pulmonologists turn to timely diagnosis & right intervention for TB therapy in the wake of no new drugs

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Pulmonologists across hospitals in the country are now apprehensive that there are no new drugs to treat tuberculosis. The country reports 12.5 million TB cases annually. India leads in TB burden, followed by Indonesia, China, Philippines, Pakistan, Nigeria and South Africa which accounts for 64 per cent of the global incidence. Even as newer drugs like bedaquiline and delaminid to treat programmatic management of drug resistant TB emerge, the concern is on novel medications to replace multidrug treatment protocol of isoniazid, rifampicin, pyrazinamide and ethambutol.

On the occasion of the World TB Day observed on March 24 with this year’s theme being ‘Wanted Leaders for a TB free world’, TB specialists are working to support Prime Minister Narendra Modi’s vision to end the disease in India by 2025 by providing quality diagnosis.

“In the present scenario TB elimination by 2025 doesn’t sound realistic. Even after 50 years of TB control programme we were not able to achieve proper control of the disease. However, genuine political commitment to implement the strategies will help to achieve this target”, said Dr P T James, HoD, Pulmonary Medicine, Amrita Institute Of Medical Sciences, Kochi.

Rising microbial resistance comes in with poor treatment compliance. The breakthrough is the introduction of PMDT drugs like bedaquiline and delaminid, besides shorter duration therapy like Bangladesh regimen of 9 months treatment instead of two years, he added.

The long-term trend is to incorporate Revised National TB Control Programme (RNTCP) in the private sector and mandate notification of TB. Continuing efforts by government for early diagnosis and treatment will prevent further infection and help TB eradication, said Dr. Jacob.

According to Dr. Shivaraj A L, Consultant, Pulmonologist, Columbia Asia Hospital, Whitefield, if TB is not treated properly, it can be fatal. New TB patients must put through the internationally recognized first-line regimen of 8 weeks: Isoniazid, rifampicin, pyrazinamide and ethambutol. This is followed by isoniazid, rifampicin and ethambutol for 16 weeks.

According to the current daily drug regimen in India, patients are prescribed 3-4 drugs in a single pill every day based on their body weight. These patients must come under Directly Observed Treatment, Short Course ((DOTS). Timely detection and the right intervention can treat and cure TB. Between 2000 and 2016, around 53 million lives were saved worldwide through proper diagnosis and treatment.

Dr. Anita Suryanarayan, VP Operations, South India and Sri Lanka, Metropolis Healthcare asserted that TB is contagious and therefore awareness is critical. A lesser known fact about TB is that it can affect other parts of the body. India lacks a proper protocol for either diagnosis or treatment.

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