SHOBHA SHUKLA - CNS
Without infection there is no disease: Nip the TB infection
Prevention of new infections of TB bacteria (Mycobacterium tuberculosis) and their progression to active TB disease is critical to reduce the burden of TB disease and to achieve the goal of ending TB by 2030.
Around 587 million (35%) of the total estimated 1.7 billion people infected with latent TB infection (LTBI) globally live in the South-East Asia region. About 7% (43.3 million) of these are children under 15 years of age. A person with LTBI does not have symptoms and cannot spread TB bacteria to others. But in some of them the LTBI will progress to active TB disease in their life. All cases of active TB come from this pool of people with LTBI.
The political declaration at the first-ever UN high-level meeting on TB in September 2018 included a target to provide TB-preventive treatment to at least 30 million people during 2018 to 2022: 6 million people living with HIV, 4 million children below 5 years of age who are household contacts of people with active TB, and 20 million other household contacts, with a view to empty this pool of latent TB.
The World Health Organization (WHO) recommends TB-preventive treatment for people living with HIV, household contacts of bacteriologically-confirmed pulmonary TB cases, and clinical risk groups in all countries.
Latent TB management
India has the highest TB burden: 27% of the global TB burden. 40% of its population (400 million people) is infected with LTBI. 10% of them (40 million) are likely to develop active TB disease in their lifetime.
Dr Rohit Sarin, Director of the National Institute of Tuberculosis and Respiratory Diseases, India, and member of Technical Working Group of government of India on LTBI, agrees that to prevent incidence of active TB disease, we have to cut down TB transmission to reduce the latent TB pool. Probably the best way to do this is to diagnose a TB patient early on and to put the patient on effective treatment so that the patient is no longer infectious and will no longer transmit, he told CNS (Citizen News Service).