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Mahesh

27/12/23 06:27 AM IST

Research shows India can shorten tuberculosis treatment

In News
  • Recent studies have found that the length of time tuberculosis patients need to stay on their regimen can be reduced from six to four months.
Burden of TB in India
  • Tuberculosis is a dreadful disease with a high mortality, and has consistently been a global health concern.
  • India accounts for around 27% of TB cases worldwide – which is the world’s highest country-wise TB burden – thanks in part to its population of 1.3 billion.
  • In the last decade, the National Tuberculosis Elimination Programme (NTEP), along with the private sector, has successfully found and treated 17.14 million people with TB, including an estimated 1.4 million children.
  • However, the COVID-19 pandemic adversely affected TB care and has threatened to reverse the gains made in reducing India’s burden.
  • Additionally, the growing problem of drug-resistant TB also threatens the progress we have made in basic disease management.
  • TB is curable but treatment is challenging.
  • For drug-sensitive TB, a patient must take the medication for six months, and this is a long period for most people.
  • The treatment also includes three or four drugs that can have side effects and are also difficult to swallow at times.
Challenges
  • The size and the taste of the tablet are not child-friendly.
  • The NTEP presently recommends a daily dose of medicines under direct observation for six months, which can be tiring for families as well.
  • It is not surprising that many paediatric as well as adult TB patients discontinue taking treatment due to its long duration and side effects.
  • Sometimes, they feel better and assume that completing treatment is optional.
  • This puts families and other people who are in close contact with a TB-affected person at risk of infection.
  • Stopping treatment prematurely can also contribute to the TB bacteria becoming drug-resistant.
Key Findings
  • Recent studies in adults who have TB in their lungs considered using a combination of new drugs and existing ones that are currently used for other diseases.
  • The SHINE trial, conducted with 1,200 children from four countries (India, Zambia, Uganda, and South Africa), also found that based on the drugs available with the NTEP, children with non-severe TB can be effectively treated in four months instead of six
  • That shortening the duration for TB medication cures the patient faster is transformational and also makes TB programme implementation more feasible.
  • Both studies had participants from India and their results have been included by the World Health Organization, in its TB treatment guidelines. However, India itself is yet to adopt the revised four-month treatment guidelines.
  • There is, in fact, another study that reported recently that a two-month treatment course could be effective as well.
Elimination of TB
  • At this time, it is up to researchers to identify the best combinations of these new drugs that are highly efficacious, the least toxic, and can be easily implemented in programmatic settings.
  • Global experience in costing has shown that the prices of newer drugs come down when there is political will and when community charters, funders, and the leaders of national programmes negotiate prices with drug manufacturers.
  • Lower costs can in turn motivate the global adoption of newer, shorter-duration, and less toxic drug combinations for diseases like TB.
  • India’s aim to eliminate TB by 2025 is ambitious.
  • The theme for World Tuberculosis Day (March 24) in 2023 was “Yes, we can end TB”, which reflects the worldwide desire to eliminate the disease by 2030.
Way forward
  • To (re)invigorate this fight, and to align with the vision of being ‘TB Free’ ahead of the global target, India must consider active screening and case detection along with new guidelines for shorter TB treatment.
  • Policymakers must also consider moving to a shorter treatment course for treating TB at the earliest.
  • If we delay, we stand to lose the fight as well as millions of lives to an ultimately curable disease.
Source- The Hindu

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