Context: The U.S. Food & Drug Administration (FDA) approved a new drug Pretomanid. The duration of treatment for drug-resistant TB can be drastically cut from 18-24 months to just six-nine months when pretomanid drug is used along with two already approved drugs — bedaquiline and linezolid.
The all-oral, three-drug regimen can also vastly improve the treatment success rate and potentially decrease the number of deaths due to better adherence to treatment.
Background:
What is Tuberculosis?
Tuberculosis, generally called TB is an infectious airborne bacterial disease caused by Mycobacterium tuberculosis, which most commonly affects the lungs but can also damage other parts of the body.
Symptoms of TB include:
- A cough that lasts more than 3 weeks
- Chest pain
- Coughing up blood
- Feeling tired all the time
- Night sweats
- Chills
- Fever
- Loss of appetite
- Weight loss
Spread of TB: TB is spread through the air. When a TB infected person coughs, sneezes, tiny droplets that contain the germs are released in the air contaminating the air around.
TB Treatment: TB treatment usually involves the patient with TB taking a combination of different TB drugs. If the correct drugs are taken for the entire duration of treatment, then they will for most patients provide a cure for TB.
There are two TB-related conditions:
- Latent TB – the bacteria remain in the body in an inactive state. They cause no symptoms and are not contagious, but they can become active.
- Active TB – the bacteria do cause symptoms and can be transmitted to others
TYPES OF TB
- MDR- Multi Drug-Resistant TB-People with TB who do not respond to at least isoniazid and rifampicin, which are first-line TB drugs are said to have MDR-TB.It occurs when bacteria develop resistance to antibiotics. 2 major causes are- Mismanagement of TB Treatment (Incomplete Dosage) and Person to Person transmission
- XDR-TB- Extensively drug-resistant TB People who are resistant to isoniazid and rifampin, plus any fluoroquinolone and at least one of three injectable second-line drugs (amikacin, kanamycin, or capreomycin) are said to have XDR-TB
As per the World Health Organisation’s Global Tuberculosis Report 2018, an estimated 4.5 lakh people across the world have MDR-TB and nearly 37,500 people have XDR-TB.
India has 24% of MDR-TB cases in the world.
Steps taken by the Indian government
- Early diagnosis of all the TB patients, prompt treatment with quality assured daily treatment regimen along with suitable patient support systems to promote adherence to prevent the development of drug resistance among any patient.
- To identify the drug resistance at an early stage, all TB patients are being screened for the detection of resistance under Universal Drug Susceptible Testing (U-DST).
- Various interventions like Integrated mechanism for management of Adverse Drug Reactions (ADRs), provision of patients & family counseling at the time of diagnosis and during the course of treatment
- The Nikshay Poshan Yojana provides 500 INR monthly to all TB notified TB patients in order to provide nutritional support and aid in the treatment of TB.
- India has signed a Loan Agreement worth US$ 400 Million with the WorldBank to help Treat and Eliminate Tuberculosis from India; The World Bank supported Program will cover Nine State in the country to achieve the target of eliminating TB by 2025.
- The National Strategic Plan 2017-25 for TB elimination by 2025 was developed in 2017 and included various interventions through multi-stakeholder engagement to reduce the burden of TB.
