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)
Guwahati hosted the first ever International Tourism Mart of the North-East on Friday.The three-day event at the Sarusajai sports complex witnesses large number of nations and a matching assemblage of delegates showcasing the tourism products and their potentiality.The event brings together diverse stakeholders of the tourism industry including tour operators, travel writers, entrepreneurs, adventurers, filmmakers, hoteliers, etc., from different parts of the globe and their engagement with their counterparts in the North-East could open up new vistas in the region’s tourism sector. The overseas delegates are coming from the ASEAN countries besides Japan, Korea, Australia, France, Germany,...
Annual Spords Day and Bhogali Bihu celebration by Assam Association Delhi will be held on January 20 at Central Secretariat Sports Ground, Binay marg, near Ashoka Hotel, New Delhi. The event will start at 10 am with flag hoisting. All are welcome.
The Department of Women's Studies, Gauhati University is planning to organise a Training Programme on Research Methodology in Social Sciences (Qualitative Research Methodology) from 4- 9 March, 2013. Eligibility Criteria: All those, pursuing their doctoral work, and college or university teachers, or members of recognized research institutions who are engaged in doctoral work or engaged in or planning to engage themselves in research work (not necessary for Ph.D.) will be eligible to apply for the programme.Intake capacity: 30Programme participation certificate:The participants will be provided with the course certificate on successful completion of the programme....
Properties worth several lakh have been reduced to ashes when a
massive fire broke out in Guwahati on Monday.
Initially, the fire broke out at a shop in Junali area which later
spread to the adjacent shops. Five fire tenders have been rushed to
the spot to douse the flames. The reason is yet to be ascertained but
according to preliminary report the fire originated from the electric
short circuit.
Security forces in Tinsukia district recovered a huge cache of
explosives on Sunday.
Acting on a tip off army and police raided a house in Laila Dhulijan
where a huge cache of explosives were recovered. These include 3
bottle grenades and 12 detonetor sticks along 2 KG RDX, 2 Chinese
grenades. The explosives were recovered after security forces arrested
an ULFA militant in the area.
In a bizarre incident that runs into a statewide shockwave, a woman allegedly hacked to death her husband during a quarrel over his persistent drinking habit in Sibsagar district on Sunday. The incident took place early on Sunday, when Lalita Chettri attacked her husband, who was in his early 40s, with an axe after the couple had an argument over the husband's drinking habit. Lalita's husband Prasad Chettri died on the spot. The woman was arrested.
Regional unit of the AATSA, Nazira organised Tea Tribes Festivel at Nazira Natiya Mandir on January 6. In this connection an open meeting was held under the presidentsip of Amulya Rajkonwar, where different senior aArtist and activist and youth leaders of the community were present. A large numbers of artists were feliciated in the Festivel. In evening a colourful cultural programmes were performed by the Tea Tribe artists.
Renowned film personality Biju Phukan has been hospitalized again on Sunday. Phukan was rushed to the Namecare Hospital after he complained uneasiness in the afternoon. He left the hospital after month long treatment of stork last week. Sources said his condition is stable.
Armed with ULFA support, GNLA spreads its diabolic tentacles in the run up to the Republic Day. A hardcore GNLA militant was killed at an encounter with security forces in Goalpara district of Assam bordering Meghalaya on Saturday. The encounter took place in Dudhnoi where dreaded militant of the Garo outfit Aasela Sangma was killed in the morning. Goalpara superintendent of police Shymal Saikia claimed to have recovered an US made carbine, 2 magzines a radio set from the spot. The encounter took place hours after police arrested a GNLA militant from the area.
Its yet another record the state set on Sunday. Altogether 15000 artists played khol in Titabor to help Sankardev get global recognition.The event took place at Mezenga Pathar in Titabor where dressed in traditional Sankari attires, 15000 artistes played khols for 15 minutes. Sponsored by Srimanta Sankardev Sanhga, the 15 minute long event is the first-ever attempt of its kind where traditional and humble khol made a global debut through the reverberation of over 15,000 khol players beating its leathery pads. According to the organizers, the attempt aims at setting a new record was dedicated to the propagation of Sankardeva's teachings and philosophies. Chief Minister Tarun Gogoi formally...
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