Fewer TB deaths in India: WHO:

Fewer TB deaths in India: WHO:

Context:

• According to a report from the World Health Organisation (WHO), death from tuberculosis in India saw a good decline from last year.
• Also, the number of new cases saw a rise of 5% increase.

What is tuberculosis?

• Tuberculosis (TB) is a multi-systemic infectious disease.
• It is caused by a bacteria called as Mycobacterium tuberculosis.
• It is a communicable disease.

What are the causes of tuberculosis?

• Microscopic droplets: Tuberculosis is caused by bacteria that spread from person to person through microscopic droplets released into the air.
• This can happen when someone with the untreated, active form of tuberculosis coughs, speaks, sneezes, spits, laughs or sings.
• HIV and TB: Infection with HIV suppresses the immune system, making it difficult for the body to control TB bacteria.
• As a result, people with HIV are many times more likely to get TB and to progress from latent to active disease than are people who aren’t HIV positive.
• Drug-resistant TB: Another reason of tuberculosis is the increase in drug-resistant strains of the bacterium.
• Drug-resistant strains of tuberculosis emerge when an antibiotic fails to kill all of the bacteria it targets.
• The surviving bacteria become resistant to that particular drug and frequently other antibiotics as well.

What are the different types of Tuberculosis?

• There are many types of tuberculosis, but the main two types are termed as:
• Active tuberculosis infection: when the disease is actively producing symptoms and can be transmitted to other people.
• Latent tuberculosis infection: when the person is infected with Mycobacterium tuberculosis bacteria, but the bacteria is not producing symptoms.
• Other forms of Tuberculosis are:
• Pulmonary tuberculosis mainly infects the pulmonary system;
• Cutaneous tuberculosis has skin symptoms;
• Miliary tuberculosis describes widespread small infected sites.

WHO’s treatment guidelines for drug-resistant tuberculosis:

• The WHO treatment guidelines for drug-resistant tuberculosis (2016 update) contain policy recommendations on priority areas in the treatment of drug-resistant tuberculosis.
• The revision is in accordance with the WHO requirements for the formulation of evidence-informed policy.

The main highlights of the WHO guidelines, 2016-17 are:

• A shorter MDR-TB treatment regimen is recommended under specific conditions;
• Medicines used in the design of conventional MDR-TB treatment regimens are now reclassified to reflect updates in the evidence on their effectiveness and safety;
• Specific recommendations are made on the treatment of children with rifampicin-resistant or MDR-TB based on a first-ever individual patient data meta-analysis;
• Recommendations on the role of surgery in MDR-TB case management are included.

What is the Revised National Tuberculosis Control Program (RNTCP)?

• Revised National Tuberculosis Control Program (RNTCP) is the state-run tuberculosis (TB) control initiative of the Government of India.
• As per the National Strategic Plan 2012–17, the program has a vision of achieving a “TB free India”.

Objectives:

• RNTCP provides various free of cost, quality tuberculosis diagnosis and treatment services across the country through the government health system.
• The program uses the World Health Organisation (WHO) recommended Directly Observed Treatment Short Course (DOTS) strategy and reaches over a billion people in 632 districts/reporting units.
• It is also responsible for carrying out the Government of India five year TB National Strategic Plans.

Loopholes in the program:

• Though the Revised National Tuberculosis Control Programme (RNTCP) has treated 10 million patients, the rate of decline has been slow.
• RNTCP failed on universal access to early diagnosis and treatment and improving case detection.
• Also, India is far from reaching the 2030 Sustainable Development Goals, i.e. reducing the number of deaths by 90% and TB incidence by 80% compared with 2015.  

What is National Strategic Plan for tuberculosis 2017– 2025?

• The national strategic plan for tuberculosis elimination (2017-2025), has set a goal of “achieving a rapid decline in burden of TB, morbidity and mortality while working towards elimination of TB by 2025.”

Highlights:

• The TB control programme plans to do away with the strategy of waiting for patients to walk in to get tested and instead engage in detecting more cases, both drug-sensitive and drug-resistant.
• The emphasis will be on using highly sensitive diagnostic tests, undertaking universal testing for drug-resistant TB, reaching out to TB patients seeking care from private doctors and targeting people belonging to high-risk populations.
• The other priority is to provide anti-TB treatment irrespective of where patients seek care from, public or private and ensure that they complete the treatment.
• The TB control programme also talks of having in place patient-friendly systems to provide treatment and social support.