A looming threat:

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.