Himachal Pradesh has begun rollout of TB preventive therapy. In Kangra, TB preventive therapy rollout began in end of 2021. With support from the International Union Against Tuberculosis and Lung Disease (The Union), latent TB test and treat model is guiding these efforts. Household contacts of TB patients are being tested for latent TB and, when eligible, are provided with TB preventive therapy, said Dr Sood.
Alarm bells on increase in TB deaths in last two years
Dr Sood is concerned on the unsatisfactory treatment success rate, as well as increase in TB deaths since last two years. If a rapid risk assessment is done at the time of TB treatment initiation, then it can help identify factors that are associated with unfavourable treatment outcomes, including risk of death. TB programmes could intensify care and support to these patients, in order to optimise treatment outcomes among them. "We are trying to address this through differentiated care. We have started to sensitize our teams on differentiated care and will rollout this approach in three months. We are also doing mortality analysis", said Sood.
Major changes warranted if we are to #endTB
When a person visits a healthcare facility to get a TB test, it is important to use the best diagnostics, like rapid tests, so that we can diagnose TB quickly and accurately and also know which drugs will work on that person (that is, if there is any drug resistance). This is also essential for ensuring that the person (if positive for TB) is put on the most effective treatment without any delay.
As per the latest WHO report, only 18% of the patients were tested with rapid molecular diagnostics at the time of diagnosis in India in 2020.
In Kangra district of Himachal Pradesh, Dr Sood said that there are 16 rapid molecular diagnostic test machines (Cartridge-based Nucleic Acid Amplification Test or CB-NAAT). Half a dozen more such machines are soon to come. Moreover, CB-NAAT machines deployed for testing COVID-19 will also be used for TB testing. "We will soon have at least one CB-NAAT machine in every block of Kangra and come closer to the dream of replacing sputum microscopy by CB-NAAT by end of this year or the following year," he said.
Dr Sood hopes that new shorter TB treatment regimens will soon reach the patients in near future. "This is also important for treatment adherence as well as for improving quality of care for our patients," he said.
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