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No other way out: We need to early diagnose TB and treat with drugs that work

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Universal DST in India by 2019

Indian government has committed to routinely diagnose every TB patient with DST by 2019 when universal DST will become a reality in India. Central TB Division is already progressing towards achieving this vision with rapidly scaled up world-class accredited laboratories across the country - fully-equipped with WHO-approved tests such as liquid and solid culture testing, LPAs, Gene Xperts, etc.

Dr Pai summarised that ideally a patient with presumptive TB should get WHO-approved test for TB and DST both at first point of contact with a health system (public or private). If the patient has TB and drug resistance to Rifampicin, then a sample from the patient has to be sent for culture profiling - but meantime standard MDR-TB treatment should commence. When culture profile test results come forth then treatment can be adjusted to ensure patient is taking all the drugs he or she is sensitive to. Adhering to effective anti-TB treatment and successfully getting cured is indeed critical to progress towards ending TB.

"Second best time is today"

"The best time to plant a tree was twenty years ago. The second best time is today" goes the old gold adage, which perfectly sums up the fight against TB. We need to solve the riddle: find every missing case of TB, correctly and early diagnose every presumptive case of TB with WHO approved tools and tests, get to know which drugs a particular patient is sensitive or resistant to so that effective standard anti-TB therapy can commence without any delay, ensure adherence, ensure infection control, contact tracing, treatment monitoring, and doing everything we already know is critically important component of TB care and control. There is no other way out to reach the ambitious goal of ending TB.

Bobby Ramakant, Citizen News Service -- CNS

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