India will soon roll out a new drug regimen for drug-resistant TB: Director, ICMR- National Institute for Research in Tuberculosis

A health technician analyses blood samples for tuberculosis testing in a high-tech tuberculosis lab in Carabayllo in Lima, Peru May 19, 2016. REUTERS/Mariana Bazo SEARCH "TB HOPE" FOR THIS STORY. SEARCH "THE WIDER IMAGE" FOR ALL STORIES. TPX IMAGES OF THE DAY - S1AEUOHDOHAA

The National Institute for Research in Tuberculosis under the Indian Council for Medical Research is a World Health Organisation collaborating centre for TB research and training and has played a significant role in reducing the burden of the highly infectious disease in India. On the occasion of World TB Day, Moneycontrol caught up with its director Dr Padmapriyadarsini to understand the status of the disease in India and how the country’s fight against it is progressing.

What are the latest developments in TB research and treatment?

The field of tuberculosis (TB) research and treatment has made significant progress in recent times, with several noteworthy developments. The new TB treatment regimens are a major breakthrough, as they offer shorter treatment durations and improved outcomes for both drug-resistant and drug-sensitive TB cases. The fact that we have a potential treatment which is a fully oral, non-injectable 6-9 month regimen for drug-resistant TB is a significant development. Similarly, there is ongoing research for a 4-month regimen for drug-sensitive TB that is much shorter than the previous 6-9 month regimen, making it more feasible for patients to complete the full course of treatment. Preventive therapy through vaccination is another promising potential development in TB research. This once-weekly preventive therapy for 12 weeks can potentially be an effective way to administer the vaccine and can provide lasting protection against TB infection. The emergence of more precise and rapid diagnostic tests with drug susceptibility is also a significant development. These tests can accurately diagnose TB infection and determine the most effective treatment regimen, thereby reducing the risk of drug resistance and improving treatment outcomes.

Could you highlight some findings from the National TB Prevalence Survey in India that indicate the public health burden of TB?

The results of the National TB Prevalence Survey indicate that certain states in the country have a high incidence of TB. While India has made major strides, the survey found that a significant portion of the population (over 60 percent) was not aware of the symptoms of TB and did not know where to seek help. This lack of awareness and knowledge is a significant barrier to controlling the spread of TB. If people do not know the signs of TB, they may not seek medical attention, and the disease can continue to spread unchecked. Moreover, the survey results indicate that the prevalence of TB is increasing in the elderly age group. This is particularly concerning because older adults are more vulnerable to the severe effects of TB, which can lead to more significant health complications and a higher mortality rate.

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How does drug resistance develop in TB, and what are the implications for treatment?

Drug-resistant tuberculosis (DRTB) is a significant public health concern, and it arises mainly due to the irregular and incomplete treatment of the disease. When TB patients do not take their prescribed medication as directed, it allows the TB bacteria to develop resistance to the drugs. Similarly, missed doses of medication can also contribute to the development of drug-resistant TB because it creates an environment in which the TB bacteria can grow and spread without being controlled by the medication. Moreover, delays in TB diagnosis can also lead to drug-resistant TB. When a TB patient is not diagnosed promptly, the bacteria can continue to multiply and spread, increasing the likelihood of the development of drug-resistant strains. It is important to encourage and prioritise adherence to treatment regimens and early and accurate diagnosis of TB in order to reduce the incidence of drug-resistant TB and improve the overall health outcomes of those affected by this disease.

What can India do to accelerate the rollout of the new drug regimen for drug-resistant tuberculosis?

India will very soon roll out a new drug regimen for drug-resistant TB. The new regimen is expected to offer improved treatment outcomes and reduce the burden of the disease on patients and healthcare providers.

What role does vaccination play in preventing tuberculosis, and is it recommended for everyone?

The development of a TB vaccine has been a priority in the fight against TB as it could help prevent new infections and reduce the spread of the disease. There is ongoing research and it is expected that the results of these studies will be available soon. If the vaccine is found to be effective and beneficial it may be recommended for people who have been in close contact with patients with TB, such as family members or healthcare workers. This would help in protecting these individuals from contracting TB and reduce the risk of transmission to others.

What may be the potential consequences of not addressing India’s TB burden?

The burden of TB in India is a matter of great concern. Failure to address this issue could have severe consequences for the country's economic growth and the well-being of its citizens. As a developing nation with a young population, India is particularly vulnerable to the negative impact of uncontrolled TB. The disease can lead to significant morbidity and mortality, reduce workforce productivity and increase healthcare costs, among other things. To address this issue, India must prioritise the prevention, detection and treatment of TB.