India is gearing up to strengthen tuberculosis (TB) control so as to provide TB prevention, diagnostics and treatment, particularly for multi-drug resistant tuberculosis (MDR-TB), nation-wide by 2010.
MDR-TB is TB that is resistant to at least two of the best anti-TB drugs, isoniazid and rifampicin. These drugs are considered first-line drugs and are used to treat all persons with TB disease.
"The 4th Global Survey on anti-TB drug resistance does not indicate that the rates of MDR-TB are increasing sharply in India or in Indonesia, or in the South-East Asian Region as a whole. The overall rates for MDR-TB among new smear-positive cases in the Region is 2.8% among new cases and 18.8% among people receiving prior treatment for TB for one month or more. However given population sizes in our larger countries, the numbers of cases are indeed large" said Dr Jai P Narain, Director, Communicable Diseases Department, South East Asian Regional Office (SEARO) of the World Health Organization (WHO).
MDR-TB is a result of inadequate programme performance of Directly Observed Treatment Short-Course (DOTS). DOTS is the WHO-recommended treatment strategy for detection and cure of TB which combines five elements: political commitment, microscopy services, drug supplies, surveillance and monitoring systems and use of highly efficacious regimes with direct observation of treatment.
"National TB control programmes in our Region have moved steadily to achieving the case detection and treatment success targets under DOTS. Treatment success rates in excess of 85% have been consistently achieved since 2002" further explains Dr Narain.
However due to a broad range of reasons, some people with drug-susceptible TB (which is not resistant to any anti-TB drug) develop resistance to anti-TB drugs, or may contract the drug-resistant strain of TB, which is also a possibility. People living with HIV (PLHIV) or those with compromised immunity are at particularly alarming TB risk (both drug susceptible and drug-resistant TB strains).
"MDR-TB cases arise among patients failing Category 1 and 2 regimens, contacts of MDR-TB cases, congregate settings and in other at risk populations such as PLHIV" adds Dr Narain.
Testing or diagnosing these drug-resistant strains of TB and providing effective medication (which is many times more expensive, and treatment duration is much longer) and improving DOTS programme performance for successfully diagnosing and curing drug-susceptible TB (and preventing development of any further anti-TB drug-resistance) can certainly make TB control more effective.
"We see this as an opportunity to strengthen our efforts to focus on prevention of MDR-TB so that we do not have to make the larger investments in treating additional cases of MDR-TB" says Dr Narain.
"India has adopted policy and is now rapidly building laboratory capacity through a network of 24 reference laboratories qualified to undertake culture and drug susceptibility testing (DST) to offer testing to all those who may have drug-resistant forms of TB. There is also an expansion plan to treat MDR-TB cases country-wide by the end of 2010" informs Dr Narain.
Dr Narain points out two specific areas that require attention: To determine how/ where MDR-TB is being generated, and to prevent further emergence of MDR-TB.
While achieving good cure rates under DOTS, we need to focus also on reasons for default and other unfavourable outcomes" says Dr Narain. "Given good cure rates under DOTS, are most MDR-TB cases arising from unsupervised treatment, through unsustainable out-of-pocket expenditure, outside of DOTS programmes?" asks he.
Dr Narain suggests some ways to prevent further emergence of MDR-TB. "By addressing all causes of adverse TB treatment outcomes, enhancing involvement of private sector and unlinked public health facilities, and promoting wider acceptance and application of the International Standards of TB Care" can possibly improve TB programmes in the region.
(The author is a Special Correspondent to Citizen News Service (CNS). He can be contacted at: amit@citizen-news.org)
5 Sep 2015 - 8:13am | AT News
A surging water level of the Brahmaputra is posing a serious threat to Guwahati city forcing the authority to keep the denizens on maximum alert.If the mighty river maintains the surging trend,...
18 Oct 2007 - 1:33pm | luitneildon
The Army has adopted psychological methods to make an appeal to the cadres of United Liberation Front of Asom (ULFA) to shun violence and join the mainstream. As a part of this initiative, a large...
25 Feb 2010 - 11:18pm | editor
ULFA publicity secretary Mithinga Daimary was freed on Thursday 48 hours after he procured bail from a local TADA court. The jailed ULFA top gun who has been languishing in Guwahati after he was...
23 Jul 2010 - 6:25pm | Mowsam Hazarika
Dr. Himanta Biswa Sarma rushed to the Barpeta on Thursday evening, immediately after reaching Guwahati from New Delhi. The southern district of ASSAM, Barpeta, plunged into a state of crisis and high...
Wanna do online journalism? You can do if you are confident and workaholic. Need only an online training. We at Assam Times are ready to help you translate your dream in this roaring job. Come January 1, 2018.
Register now for online course free of cost and get the advantage. Manned by a team of sharp and dedicated journos of international repute we are coming up from the new years day.
Yet another witch hunting incident fans no less shock and anger across the on Monday two days after it came to light. The incident took place at a remote helmet in Chirang district bordering Bhutan where thr body of the victim was recovered on Saturday. Identified as Guneswar Basumatary, the local resident of Koila Moila near Dotom was believed to have been killed alleging witch craft. According to family members,Guneswar went missing on September 16 evening he visited his relative's house at Koila Moila area. Family members lodged an FIR with Amguri PS,case number 45/2017, under section 302/201 IPC. During a search operation, police and family members recovered body in decomposed...
A local magistrate in Nagaon on Friday remanded Mithu Roy to two days police custody after the trader was produced before it in connection with the recent incident where he and his associates thrashed four former ULFA rebels who approached him for fund to feed the flood hit people. According to allegations, he was the main culprit who hired a few local associates to beat up the youths who were raising fund. He was arrested on Thursday as he was on the run as police arrested his three associates on Wednesday afternoon. Meanwhile, a huge gathering in the central Assam town demanded examplary punishment of the accused youths saying that they...
A candle lighting rally was carried out at Salakati in protest against killing of ABMSU leader Lafikul. The was organized by ABMSU and was participating by ABSU, AKRSU, bengali Federation, Santhali Student's Union and many organizations. The rally was started from Salakati anchalik Abmsu office and concluded at Railway gate. Thousands housands of activists from various student's union and civilians participated and demanded early arrests of main culprits.The ABMSU demanded CBI inquiry into Lafikul murder,arrest main culprits and provide safety and security to the persons of the region. Moinuddin Ali,ABMSU leader said that main culprits should be nabbed as soon as possible...
United Liberation Front of Asom (Independent) said The Nagas Nation has lost a true and uncompromising Nationalist. "In the creation of Western South East Asia geographic identity with an organic soul giving hope to even the smallest nationality of the region opportunity to get just political representation amongst the family of Nations reflects his deep understanding and vision in keeping with his superb statesmanship". Describing him as a 'Grandee' of the indigenous citizens of the WESEA region, ULFA(I) chairman Dr Abhizeet Asom in his condolence message to media said "as the Chairman of United Liberation Front of Western South East Asia, he brought an affinity amongst the...
Amid an escalating controversy over beef consumption, yet another leader has quit BJP in Meghalaya suggesting a setback for the saffron party in the pre poll political landscape. North Garo Hills BJP president Bachu Marak pulled out of the party after the national party spokesman Nolin Kohli warned him against a beef party in Tura to celebrate the three years of the NDA government at the Centre. Marak, who pulled many people to BJP in the Congress ruled state rued in his resignation letter to state party president Sjibun Lyngdoh made it plain and simple that he would never go against the sentiment of the Garo people for whom beef is an inevitable item at any feast. He...
A crucial meeting of BPF and AGP leadership with Amit Shah is clearing the decks for the expansion of Sarbananda Sonowal cabinet slated for April 15. Senior BJP leader Himanta Biswa Sarma along with AGP president Atul Bora, his BPF counterpart Hagrama Mohilary is meeting the BJP president in New Delhi on Monday where the entire process would be finalized. Sources told www.Assam Times that Bongaigaon legislator Phani Bhushan Chaudhury is likely to be inducted in the cabinet from AGP. Both AGP and BPF will have one each in the cabinet while BJP will have six new faces in the expanded cabinet. Those who are attending the close door meet include Hagrama Mohilary, Arul Bora, Hemant Biswa...
In a bizarre incident that triggers statewide anger and surprise, the police have arrested a top ranked officer in Dispur on bribery charges on Tuesday before recovering more than Rs 1 crore from his possession.He is none other than Kujendra Doley, the irrigation secretary who alleged to have been collecting lakhs of rupees from the contractors for releasing their bills.Acting on a complaint from a contractor, the sleuths of the vigilance and anti corruption cell caught the secretary red handed and seized an astronomical amount of money from his office locker he allegedly to pay minister Ranjit Dutta.Then Doley was taken to his residence in the city and Rs 10 lakh were seized in cash during...
Add new comment