Randomized control trials: the technique that transformed TB care
- Tuberculosis is caused by Mycobacterium tuberculosis (bacterial infection).
- Before antibiotics, TB treatments were largely care intensive, surgical procedures like lobectomy and pneumonectomy were performed by expert cardiothoracic surgeons.
- The discovery of antibiotics by Sir Alexander Fleming marked the beginning of a new chapter in the fight against this persistent foe.
- However, the real revolution in TB treatment was brought on by the ground-breaking work of Sir Austin Bradford Hill.
Tuberculosis in India:
- With 25,37,235 TB cases notified in 2023, India has bettered the TB notification number achieved in 2022.
- The TB notification by the public sector reached 93% of the target, it was 89% in the case of the private sector.
Challenges
- Poor primary health-care and infrastructure in rural areas;
- Unregulated private health care;
- HIV induced TB cases
- Lack of hygiene facilities and widespread malnourishment and poverty.
India's Efforts:
- Pradhan Mantri TB Mukt Bharat Abhiyan
- National Strategic Plan (NSP) for Tuberculosis Elimination (2017-2025)
- TB Harega Desh Jeetega Campaign
- Nikshay Poshan Yojna
- RePORT India: RePORT India (Regional Prospective Observational Research for Tuberculosis (TB)) is a bilateral, multi-organizational, collaborative effort established in 2013 under the Indo-US Vaccine Action Program (VAP).
- It aims to address the threat of TB to the people of India and across the globe.
- Bharat Biotech, based in Hyderabad, has started clinical trials of MTBVAC, the world's first Mycobacterium tuberculosis vaccine derived from a human source, in India
Drugs for TB:
- Isoniazid (INH):It works by inhibiting the synthesis of mycolic acids in the bacterial cell wall.
- Rifampicin (RIF): Rifampicin works by inhibiting the synthesis of RNA in the bacteria.
- Delamanid: Delamanid is a newer drug that is used in the treatment of multidrug-resistant TB (MDR-TB) used in combination with other drugs.