India is gearing up to strengthen tuberculosis (TB) control so as to provide TB prevention, diagnostics and treatment, particularly for multi-drug resistant tuberculosis (MDR-TB), nation-wide by 2010.
MDR-TB is TB that is resistant to at least two of the best anti-TB drugs, isoniazid and rifampicin. These drugs are considered first-line drugs and are used to treat all persons with TB disease.
"The 4th Global Survey on anti-TB drug resistance does not indicate that the rates of MDR-TB are increasing sharply in India or in Indonesia, or in the South-East Asian Region as a whole. The overall rates for MDR-TB among new smear-positive cases in the Region is 2.8% among new cases and 18.8% among people receiving prior treatment for TB for one month or more. However given population sizes in our larger countries, the numbers of cases are indeed large" said Dr Jai P Narain, Director, Communicable Diseases Department, South East Asian Regional Office (SEARO) of the World Health Organization (WHO).
MDR-TB is a result of inadequate programme performance of Directly Observed Treatment Short-Course (DOTS). DOTS is the WHO-recommended treatment strategy for detection and cure of TB which combines five elements: political commitment, microscopy services, drug supplies, surveillance and monitoring systems and use of highly efficacious regimes with direct observation of treatment.
"National TB control programmes in our Region have moved steadily to achieving the case detection and treatment success targets under DOTS. Treatment success rates in excess of 85% have been consistently achieved since 2002" further explains Dr Narain.
However due to a broad range of reasons, some people with drug-susceptible TB (which is not resistant to any anti-TB drug) develop resistance to anti-TB drugs, or may contract the drug-resistant strain of TB, which is also a possibility. People living with HIV (PLHIV) or those with compromised immunity are at particularly alarming TB risk (both drug susceptible and drug-resistant TB strains).
"MDR-TB cases arise among patients failing Category 1 and 2 regimens, contacts of MDR-TB cases, congregate settings and in other at risk populations such as PLHIV" adds Dr Narain.
Testing or diagnosing these drug-resistant strains of TB and providing effective medication (which is many times more expensive, and treatment duration is much longer) and improving DOTS programme performance for successfully diagnosing and curing drug-susceptible TB (and preventing development of any further anti-TB drug-resistance) can certainly make TB control more effective.
"We see this as an opportunity to strengthen our efforts to focus on prevention of MDR-TB so that we do not have to make the larger investments in treating additional cases of MDR-TB" says Dr Narain.
"India has adopted policy and is now rapidly building laboratory capacity through a network of 24 reference laboratories qualified to undertake culture and drug susceptibility testing (DST) to offer testing to all those who may have drug-resistant forms of TB. There is also an expansion plan to treat MDR-TB cases country-wide by the end of 2010" informs Dr Narain.
Dr Narain points out two specific areas that require attention: To determine how/ where MDR-TB is being generated, and to prevent further emergence of MDR-TB.
While achieving good cure rates under DOTS, we need to focus also on reasons for default and other unfavourable outcomes" says Dr Narain. "Given good cure rates under DOTS, are most MDR-TB cases arising from unsupervised treatment, through unsustainable out-of-pocket expenditure, outside of DOTS programmes?" asks he.
Dr Narain suggests some ways to prevent further emergence of MDR-TB. "By addressing all causes of adverse TB treatment outcomes, enhancing involvement of private sector and unlinked public health facilities, and promoting wider acceptance and application of the International Standards of TB Care" can possibly improve TB programmes in the region.
(The author is a Special Correspondent to Citizen News Service (CNS). He can be contacted at: amit@citizen-news.org)
At least ten persons have been injured when a local train collided with a railway engine in Dibrugarh district on Wednesday. The incident took place at M E S Tiniali area near Chabua town of the district at around 7 in the evening. The Dibrugarh-Ledo passenger train was coming towards Dibrugarh when it collided head on with a pilot engine going to the opposite direction. All the injured have been shifted to local hospitals and rescue operations are still going on at the site.
Christmas festivity grips Assam from Monday with churches wearing a fresh look across the state. Christian people across the state thronged the churches from Monday midnight with carols and prayers.From early in the morning on Tuesday people are line up in front of the churches for prayers. People from all walks of life are gathered in the churches for the special Christmas Vigil services being held across the state to celebrate birth of Jesus Christ. In the heart of Guwahati, Nagaon, Jorhat, Tezpur, the young and the old and the rich and the poor all offered special prayers on the eve of Christmas.
Amid the hail of protest against rape in Delhi and molestation in Manipur, a 22-year-old girl in Sivasagar alleged inaction by the police in a case of molestation filed by her against six persons. The girl, who is pursuing a university law student, was allegedly molested by the six outside her home in daylight at Joysagar on August 8. According to her, the six had disrobed her and beat her with sticks when she resisted them.The girl later filed a complaint at Joysagar police station and one of the accused was arrested a few days later and sent to jail but the other five are still free. Meanwhile, chargesheet had been filed on the case and the five accused are on the run.
In yet another landmark judgment, a lower court in Nalbari has jailed a former Assam Assembly Speaker along with two others in a nefarious teacher recruitment scam that rocked the district in 1998. Former Assam speaker Pulakesh Baruah was sentenced to two terms of rigorous imprisonment of two years each by a local court on Monday in a case of illegal appointment of teachers in Nalbari district 16 years ago.The order was passed by Chief Judicial Magistrate of Nalbari, Dibyajyoti Mahanta who also fined Baruah Rs 20,000 in the case. However, it has not said by the court whether the two terms of imprisonment would run concurrently or separately.The two terms of imprisonment were awarded under...
The National Union of Journalists (India) and Journalists Association of Assam trongly condemned the police brutality on mediapersons covering the public protest against rape incident in national capital Delhi and also the death of a photographer in police firing who was covering a protest in Imphal on Sunday.In a joint statement, issued here today NUJ(I) secretary general Ras Bihari and Journalists Association of Assam (JAA) general secretary Bhupen Goswami termed the police action in Delhi as preplanned and demanded strict action against the policemen and officers responsible for the action. “A high level delegation of the NUJ(I) leaders will shortly meet the Union Home Minister Sushil...
Journalists’ Forum Assam (JFA) has expressed shock at the killing of a local scribe in Imphal on Sunday (December 23, 2012) in the police firing. The Assam based journalist organization has urged the O. Ibobi Singh led Manipur government to investigate the incident that led to killing of Th Dwijamani (Nanao) Singh and compensate his family.Mentionable is that Nanao Singh, 30, who used to work as a stringer camera person for Prasar Bharati, was killed on the second day of indefinite strikes called by the protesters asking actions against an NSCN-IM leader (Livingstone Anal), who allegedly molested a Meitei film artiste on December 18 last.“Nanao Singh was killed this afternoon when the...
Can a woman be raped, gang-raped, tortured and even murdered, and the men who did it get away scot-free? Why is the Indian army being allowed to get away with rapes and murders of women in India? Why is its morale sustained by repeated sexual violence against women and wanton killing of local population? Why are army and various security forces above the law? Why is there extensive denial of sexual assault in the power corridors? Why do women complainants and accused have to live in the fear of sexual assault by police or other security forces where they are present? Why do these forces entrusted with the security of the nation become threats to the security of innocent women and children?...
Holding placards scores of students rallied through Duliajan Township on Friday to spread the message related to protection of girl child and mother-child health etc. The rally was a part of health awareness campaign organized by Directorate of Field Publicity, Ministry of Information and Broadcasting, Dibrugarh with a view to make people aware about health schemes run by government.The campaign organized at Duliajan BM Junior college campus in co-ordination with Prasiddha (NGO) and Surjudaya (NGO) and the main awareness meeting was held in continuation with college’s second foundation day. Presided over by Principal Bulimoni Neog, the number of resource persons educated the students...
A traditional food festival is underway at organized at Silpagram, Guwahati. The event is being organised by North East Zone Cultural Center.
Photo: UB PHOTOS.
ASEAN—India Car Rally has reached Guwahati on Sunday receiving cheers from thousands of people since it entered the state. The 31 vehicles participating in the rally entered Assam to be received at the border near Nambor Reserve Forest by Golaghat Deputy Commissioner Sanjiv Gohain Boruah.
Then they headed for Numaligarh Refinery Limited where they were given a rousing welcome. The participants were also welcomed at the Kaziranga National Park by a cavalcade of elephants.
The ASEAN—India Car Rally 2012, jointly organised by the Ministry of External Affairs, Government of India and the Confederation of Indian Industry (CII), began on November 26 at Yogyakarta in Indonesia...
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