A looming threat:India gets hold of a looming disease Context:
- All children diagnosed with TB must get pediatric fixed-dose combination drugs.
- A proactive approach to testing helps in early and correct diagnosis of all contacts and in cutting the transmission chain.
Stats:
- About 5,500 of over 76,000 children tested in nine Indian cities have been diagnosed with tuberculosis, 9% of them with multi-drug resistant TB (MDR-TB), highlighting the silent spread of the disease.
- According to a 2015 study, of the over 600 children who had tested positive for TB in four cities, about 10% showed resistance to Rifampicin, a first-line drug.
The concern:
- TB in children from these nine cities is a grim reminder of the failure of the health-care system to diagnose the disease early enough in adults and start them on treatment.
- With up to a couple of months’ delay in diagnosing the disease, there is a continuing threat of TB spreading among household contacts and in the larger community.
The Initiative:
- In line with World Health Organisation guidelines, the RNTCP (Revised National Tuberculosis Control Program) requires all household contacts, particularly children, of a newly diagnosed pulmonary TB patient to be tested and started on treatment if needed.
- Children below six years of age in the household of a newly diagnosed patient are required to be given the drug Isoniazid as a prophylactic even when they do not have the disease.
- In 2010, WHO had revised the dosage of certain TB drugs for children. But Fixed-dose Combination (FDC) drugs that take into account the revised dosages for children were finally made available in late 2015.
- After more than a year’s delay, a few months ago in 2017, India finally introduced FDCs in six States. The remaining States will be covered by the end of the year.
