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Mahesh

07/09/22 21:07 PM IST

Short Anti-TB Regimen (BPaL)

In News 
  • Recently, a short tuberculosis treatment regimen of six months called BPaL as against the usual 18-month protocols has won the scientific vote with trials in multiple countries showing it had favourable outcomes in 84% to 94% of the sickest TB patients.
About BPaL 
  • In India the three-antibiotic combination is still under clinical trials and the regimen could be included in the national TB programme.
  • Three doses: While two components pretomanid and bedaquiline are novel drugs developed by TB Alliance and Johnson & Johnson. Linezolid is an old generic drug.
  • The three drugs are approved in India.
  • It is an oral regimen.
  • WHO: the WHO has approved regimens containing pretomanid for all forms of drug-resistant TB.
Importance 
  • There has been no mortality among BPaL trial patients even though most had advanced disease.
  • BPaL regimen is approved by the U.S. Food and Drug Administration (FDA) for the treatment of adults with pulmonary extensively drug-resistant tuberculosis (XDR-TB) or multidrug-resistant TB (MDR-TB) that is treatment-intolerant or non-responsive.
  • Oral treatment: Patients no longer have to undergo painful daily injections for months.
Burden of TB in India 
  • India has the world's highest TB burden - 2.6 million active cases and close to 450,000 deaths each year from the infectious bacterial disease.
  • Mumbai is often called the capital of drug-resistant TB cases.
  • It has the largest number of TB patients on the newer short which is injectionless BPaL in India.
  • TB Alliance- It is the New York-based non-profit that discovers and offers drugs to fight tuberculosis (TB).
  • XDR-TB- Extensively drug-resistant tuberculosis (XDR-TB) is a rare type of multidrug-resistant tuberculosis (MDR-TB) in which several of the most effective and core anti-TB drugs fail to work against microbial activity.
About TB 
  • It is caused by Mycobacterium tuberculosis (bacteria) and it most often affects the lungs.
  • Transmission- TB is spread through the air when people with lung TB cough, sneeze or spit.
  • A person needs to inhale only a few germs to become infected.
  • With TB infection, a person gets infected with TB bacteria that lie inactive in the body. This infection can develop into TB disease if their immune system weakens.
  • Symptoms -  Prolonged cough, chest pain, weakness/fatigue, weight loss, fever, etc.
  • Often, these symptoms will be mild for many months, thus leading to delays in seeking care and increasing the risk of spreading the infection to others.
  • Diagnosis- In the case of suspected lung TB disease, a sputum sample is collected for testing for TB bacteria.
  • For non-lung TB disease, samples of affected body fluids and tissue can be tested.
  • WHO recommends rapid molecular diagnostic tests as initial tests for people showing signs and symptoms of TB.
Source- The Hindu 

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