Report warns of rise in drug-resistant tuberculosis

Expensive Drug Regimens: While a course of standard TB drugs costs approximately Rs. 1000, MDR-TB drugs can cost more than Rs.1-1.5 lakh, and the cost of XDR-TB treatment is even higher.

A digitally colourised scanning electron microscopic image depicts a grouping of red-coloured, rod-shaped Mycobacterium tuberculosis bacteria which cause tuberculosis in human beings. On this 24 March, the people from all over the world is all set to spread the awareness about tuberculosis with the slogan "United to end TB".

Third, in the context of rapidly changing worldwide aid, predictable and sustainable funding is required to ensure adequate and uninterrupted supply of TB diagnostics materials and essential medicines thus there is the need to increase domestic funding to safeguard the achievements made so far.

Through the provision of facilities for diagnosis, treatment and prevention of the disease, attainment of high treatment success rate of over 90 per cent and reduction of financial barriers to access the appropriate care and treatment, the country is on the verge of halting the occurrence of the disease.

A National Tuberculosis Control Programme (NTP) report states that the percentage of children infected with TB rose from 4% in 2015 to 4.3% in 2016 and the total number of TB patients increased from 57% to 61% between 2015 and 2016.

The report warns the new drugs must be prescribed as individually targeted treatments with clear dosing guidelines, to prevent further resistant TB strains from emerging.

A focus will be on research in preventive and curable vaccines for the disease, it said. These patients continue to be a danger to the public and continue to spread drug resistant TB in the communities where they reside.

According to WHO Global TB report 2016, however, the number of new annual TB cases is a little higher at 362,000. In such a case, more powerful drugs are prescribed to treat the condition. Just over 58 percent of the people newly diagnosed with TB were believed to have had access to quality TB care, and this percentage fell to 20 percent for those diagnosed with multidrug-resistant TB (MDR-TB)-a term used to describe infections caused by M. tuberculosis isolates that are resistant to the two "backbone" drugs in the armamentarium against TB, isoniazid and rifampicin. On an average, 10-15 per cent of all TB patients are under the age of 14.

But new drugs have recently started entering the field to treat patients who do not respond to the existing array. But this level of testing is unavailable in many low-income countries and in most of Africa.

Fourth, strengthening of the laudable community-based health initiatives in the country to facilitate more community participation, ownership and actions to increase the geographic coverage of TB interventions.

When patients fail to follow or complete the regimen, or receive inadequate care, the disease isn't cured, and patients either die, relapse, or develop a drug-resistant strain of TB.

It adds, "XDR tuberculosis has evolved in several tuberculosis-endemic countries to drug-incurable or programmatically incurable tuberculosis [totally drug-resistant]".

After the end of World War II, Singapore made a concerted effort in the 1948 Medical Plan to tackle TB through both clinical methods (surgery to collapse diseased lungs, chemotherapy, BCG vaccination, and the conversion of Tan Tock Seng Hospital into a sanatorium) and social policy (public housing development).

And what that means is that simply doing a better job of treating drug-susceptible TB "is no longer sufficient for controlling drug resistance", according to Dowdy, lead author of a commentary that accompanies the study.

According to World Health Organization reports, the last time a drug was introduced specifically for the treatment of TB was in the late 1960s.

  • Joanne Flowers