Tuberculosis (TB) remains a major public health issue in India, which bears over a quarter of the global TB burden. Its mention can be seen in history as well as literature. When we fight against TB, we are not just helping India but the world.
Government Efforts in Controlling Tuberculosis (TB)
- The Indian government is proactive in managing TB, including tracing missed cases where individuals may have died without a diagnosis.
- In 2023, 25.1 lakh patients were diagnosed with TB, indicating enhanced case-finding efforts. Early detection is crucial for effective treatment, and the increase in diagnosed cases reflects improved detection capabilities.
- Citizen involvement and the use of proven technologies are vital in this ongoing battle.
Despite progress driven by political will and improved case-finding efforts, innovative strategies and new treatments are essential for achieving TB elimination.
Enroll now for UPSC Online Classes
Challenges
- Complexities in Treating Drug-Resistant TB: Drug-resistant tuberculosis (TB) presents a significant challenge due to the ineffectiveness of existing medicines. Current treatment regimens are either lengthy or demanding, with the shorter regimen lasting 9-11 months requiring 13-14 tablets daily, and the longer regimen lasting 18-24 months requiring 4-5 tablets daily.
- Impact of Treatment Regimens: These treatments are physically and psychologically taxing, with severe side effects such as hearing loss and psychosis. The extended regimens, necessitating nearly two years of regular clinic visits, often result in job loss and drive families into poverty.
However, a silver lining can be seen in the recent recommendation of the WHO in 2022, which recommends the shorter, safer, and more effective BPaL/M regimen for drug-resistant TB.
BPaL/M Regimen for Drug-Resistant TB
- Recent data show this regimen’s higher efficacy and better compliance, with only three to four tablets daily and a six-month treatment duration.
- It has minimal side effects and boasts a success rate of 89%, compared to the 68% success rate reported in India’s 2023 TB Report.
- Around 80 countries have already procured BPaL/M, with 20 high-burden countries already rolling it out.
- An additional advantage is its economic impact: Potential savings of 40%-90% on current treatment costs, with a projected global annual saving of 6,180 crore.
How to Improve TB Diagnosis and Detection Capabilities
- Proactive Screening: Utilise health datasets and GIS mapping to pinpoint regions with high disease prevalence. Focus on identifying vulnerable populations, such as those who are malnourished, have comorbidities like diabetes and HIV, are former COVID-19 patients, or belong to at-risk communities in slums, prisons, and among homeless populations and migrant workers. Implement targeted multi-disease screening drives to address these high-risk groups effectively.
- Asymptomatic Cases: A significant number of pulmonary TB cases lack recognizable symptoms like fever and cough. Chest X-rays are a successful way to detect such cases. The National TB Prevalence Survey (2019-21) underscores the importance of chest X-rays, which detected 42.6% of cases that would otherwise have been missed. Portable X-ray machines equipped with AI-driven tools can significantly reduce diagnostic delays, especially in remote and under-resourced areas. This approach can help identify a larger number of TB cases, making it easier to administer treatment and improve overall health outcomes.
- Rapid Molecular Tests: Traditionally, doctors would detect TB using sputum analysis (microscopy methods). However, rapid molecular tests are now more effective. These tests can be conducted at the patient’s location without needing to visit cities for detection. They also indicate which medicines would be effective. Expanding the use of rapid molecular tests over less sensitive microscopy methods is crucial for faster detection and drug resistance profiling. This shift will enable prompt identification of TB cases and appropriate treatment decisions.
Check Out UPSC NCERT Textbooks From PW Store
Conclusion
Many individuals avoid testing because they do not exhibit symptoms, leading them to overlook the possibility of TB. To address this challenge, the government must take proactive measures to identify at-risk populations and invest in advanced diagnostic technologies. By doing so, we can significantly improve TB detection rates, shorten diagnostic delays, and ensure more effective treatment, ultimately moving closer to the goal of TB elimination.
August 29, 2024
