Effective preventive therapy needed to tackle latent TB: Experts

M Somasekhar Hyderabad | Updated on November 01, 2019

Anil Mahesh, a father of 3 children, got completely treated from tuberculosis (TB), about 9 months ago. But, before the relief could sink in, he was devastated to find his daughter diagnosed with the disease.

“I did not know how she got it, and it was sad. I never knew it would spread to other members at home. I even let my wife stay separately for sometime as the kid was getting treated,” the poor employee narrated at a special session in the ongoing Union World Conference on Lung Health today. “Now, I feel, preventive therapy needs to be given to family members in a household where a person is suffering from TB,” Mahesh said.

On the other hand Lakshmi Priya, a HIV survivor complained that no prophylactic TB treatment was provided to people diagnosed with the HIV. “I hear that HIV and TB are co-existing and hence require attention.”

These are the voices of people suffering from infectious diseases, especially TB, which is impacting large populations in developing nations and is an emerging problem faced by high-risk groups.

‘Silent infection’

While India carries the highest burden of TB, with an estimated 2.69 million cases in 2018, a bigger alarm bell could be the a high number of people harbouring Latent TB Infection (LTBI), experts warn.

According to rough estimates, about 40 percent of the country’s population could have this ‘silent infection’. The first United Nations High Level meeting on TB in 2018, declared that globally at least 30 million people should be tested and put on preventive treatment by 2022.

Since, India has the largest number of TB patients, the onus is on the country to take the declaration as an opportunity to initiate work and address issues of surveillance, diagnosis and preventive treatment holistically, speakers at a session in the ongoing Union World Conference on Lung Health said.

Protecting high-risk groups

According to Rohit Sarin, Director, National Institute for Tuberculosis and Respiratory Diseases, New Delhi, the the available tests for high-risk groups are not as good as desired. This group of people include those living with HIV patients, household contacts, those living with TB patients, those on immunosuppressants, dialysis, migrants etc.

The good news is that effective treatment regimens are available, but the bad news is that the coverage is still inadequate and needs to be improved quickly, he added.

Sundari Mase, Independent TB consultant, said that of the 10 million TB patients who are reported to the WHO annually, a good percentage of them are those progressing from LTBI. “In terms of risk, those with diabetes are 4 times, with HIV it’s 10 times and for children below 5 years, it is too high.”

The national plan is to expand the access of the preventive care, and reach all those eligible by 2023. “The government is trying to involve private players too. Seven states have committed to completely eliminating TB,” says KS Sachdeva, Deputy Director General, Revised National Tuberculosis Control Programme.

At present, the efforts towards LTBI are at best modest, experts felt.

Published on November 01, 2019

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