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06 July 2022 – The Hindu

EDITORIAL ANALYSIS à 06 JULY 2022 à THE HINDU:

TB CONTROL IN INDIA:

Details of Tuberculosis:

Lungs are impacted by the condition known as tuberculosis.
The most prevalent site of tuberculosis, the lungs, is caused by bacteria (Mycobacterium tuberculosis).
Since anti-TB medications have been around for a while, strains that are resistant to one or more of them have been found in every country that has been researched.
A form of tuberculosis known as MDR-TB is brought on by germs that are resistant to the two most potent first-line anti-TB drugs, isoniazid and rifampicin.
Second-line medications can be used to treat and eradicate MDR-TB.
A more dangerous variant of MDR-TB known as extensively drug-resistant tuberculosis (XDR-TB) is caused by germs that are resistant to the best second-line anti-TB drugs, leaving patients with few further treatment options.

There are numerous causes of tuberculosis, including:

People can contract tuberculosis from one another through the air.
The TB bacteria are released into the air when people with the disease cough, sneeze, or spit.
By having direct touch with an infected person, one can develop tuberculosis (TB), an airborne sickness that is contagious.
Mycobacterium tuberculosis is one of the most frequent causes of tuberculosis.
The likelihood of developing tuberculosis is higher in young children and the elderly.
People with HIV or diabetes, who already have a compromised immune system, are more susceptible to this infectious disease.

Four different varietiesof tuberculosis-causing bacteria make up the pathogenic bacterial species known as Mycobacterium tuberculosis.

Mycobacterium bovis
The mycobacterium Canetti
African mycobacterium known as Microti

Diagnosis of tuberculosis:

Physical examinations are not the only way to check for the presence of pathogenic germs; other tests are also available.
These tests can include chest X-rays, skin tests, blood and sputum tests, and more.
Blood Test: This procedure involves taking blood samples and having them analysed in labs to determine whether or not the blood cells contain tuberculosis bacteria.
Skin tests are the most typical type of test. In this procedure, a small amount of tuberculin, a pure protein, is injected beneath the patient’s skin.
A tuberculosis infection is evident if the skin around the injection site expands by more than five centimetres.
This test is known as the Mantoux tuberculin skin test (TST).

TB Signs and Symptoms:

The TB bacteria, also known as Mycobacterium tuberculosis, are typically located in the lungs and can result in significant symptoms like:

Coughing up blood
Fatigue and weakness
Night time sweats
Chest discomfort

The TB bacteria, also known as Mycobacterium tuberculosis, are typically located in the lungs and can result in significant symptoms like:

Gain less weight
Appetite decline
Chills that appear out of the blue
Fevers & Chills

Treatment for tuberculosis:

It is possible to treat and cure tuberculosis.
The patient receives a standard six-month course of four antimicrobial drugs together with counselling, oversight, and assistance from a medical professional or qualified volunteer.
Utilizing medication is one of the best approaches to manage this viral ailment.
Patients with latent tuberculosis infections typically receive an antibiotic called isoniazid from their doctors in order to prevent the disease from becoming active.
Active TB illnesses can be lethal if left untreated.
The procedure comprises taking ethambutol, INH, priftin, and pyrazinamide for three months, then INH and pyrazinamide for 12 months.

Tuberculosis with Drug Resistance:

Multi-Drug Resistant Tuberculosis (MDR-TB), which develops in the host body due to a lack of treatment medications and is not completely removed from the body due to an interruption in antibiotic therapy, is a concern that is shared by many people.
Because the germs are resistant to first-line anti-TB treatments, the host is treated with second-line anti-TB therapies.
Due to a large concentration of TB in one area, extensively drug-resistant tuberculosis (XDR-TB) develops in the host body and is challenging to treat.
One or two second-line medications are ineffective against the XDR-TB bacteria strain.
Ineffective management of this circumstance could lead to more bacterial mutations and total drug resistance, commonly known as total drug resistance tuberculosis (TB).
With more than 2 million cases recorded in 2018, India is the country with the highest rate of tuberculosis.
While rejecting those that would not increase TB research and development (R&D), the Indian government promotes the creation of novel instruments.
The Indian government aims to create plans in collaboration with the Ministry of Science and Technology, the Ministry of Health, and other research-oriented pharmaceutical companies in order to achieve the nation’s TB elimination targets.
Case-finding initiatives have been taken into consideration in order to avoid delays in the diagnosis of tuberculosis.

The government makes the following efforts to fight tuberculosis:

By 2025, the Indian government wants there to be no more cases of TB.
In order to commit to this objective, the Ministry of Health and Family Welfare created the National Strategic Plan (NSP) for TB Elimination in 2017.
The National Strategic Plan will oversee the creation of the national project implementation plan (PIP), state PIPs, and district health action plans (DHAP) under the National Health Mission (NHM).

The National Strategic Plan for the Elimination of TB:

All stakeholders, including the national and state governments, development partners, civil society organisations, international organisations, research institutions, the private sector, and others whose work is pertinent to the eradication of tuberculosis in India, will follow this framework in all of their activities.

This initiative is supported by four strategic pillars, DTPB, as explained below:

VISION: An India free from tuberculosis, with no illness, no poverty, and no deaths.
OBJECTIVE: To lessen the toll of tuberculosis on morbidity and mortality while pursuing TB eradication in India by 2025.
The four PILLARS of the NSP for TB Elimination are Detect – Treat – Prevent – Build (DTPB).

The following characteristics of the National Strategic Plan for TB Elimination:

All tuberculosis patients will have been identified by 2020, and the illness will be fully gone by 2025.
The Conditional Access Program has approved the anti-TB medication bedaqualine (CAP).
Under the Make in India initiative, it was suggested that the public sector produce a first-line anti-TB drug.
A goal of the NSP is to create a TB corpus fund under the auspices of the India TB Control Foundation, also known as Bharat Kshay Niyantran Pratishthan (BKNP).
By switching from a regulatory to a partnership-based approach to streamlining services in the mostly chaotic and unregulated private sector, it seeks to achieve synergy.
The creation of E-Nikshay, a user-friendly online platform that enables practitioners to record cases as soon as they come across an infected patient, is an example of technology implementation.
Educating the public about tuberculosis and ways to prevent it is essential. Media campaigns to support TB prevention are being planned as part of this programme. One such programme is Swasth E- Gurukul from the World Health Organization.

NIKSHAY PLAN:

The NIKSHAY system is assisting the nation in achieving almost total online patient notification.
An all-in-one platform for managing patient data and monitoring programme activity and performance across the nation is called Nikshay.
It was created and is maintained by the Central TB Division (CTD) of the Ministry of Health and Family Welfare in collaboration with the National Informatics Centre (NIC) and the WHO Country Office for India.

Additional government programmes to fight TB include:

Nikshay Ecosystem is a national tuberculosis information system that provides a one-stop location for managing patient data and monitoring programme activities and performance nationwide.
the Nikshay Poshan Yojana The NYP plan was developed to provide financial aid to TB patients so they may improve their nutrition.
The TB Harega Desh Jeetega campaign was introduced in September 2019 with a commitment to eradicating tuberculosis at any costs.

The Saksham Project was started by the Tata Institute of Social Sciences (TISS) to provide drug-resistant tuberculosis patients with psychosocial therapy.

The Annual Tuberculosis Report for India for 2020:

There were 20.04 lakh registered TB patients in India in 2019, up 14% over the previous year.
decreased the amount of missing cases from above 10 lakh in 2017 to 2.9 lakh in 2018.
78 lakh new cases of TB were reported in the private sector, a 35 percent increase.
From 6% in 2018, the percentage of children with tuberculosis (TB) diagnoses increased to 8% in 2019.
HIV testing increased from 67 percent in 2018 to 81 percent in 2019 for all tuberculosis patients who had been notified.
The extension of treatment options has led to a 12 percent increase in the treatment success rate for patients who have been informed.
Compared to 69 percent in 2018, it is 81 percent in 2019.