Health Magazine

TB Or Not TB: World TB Day–No More TB

Posted on the 24 March 2012 by Pranab @Scepticemia

Today is the World Tuberculosis Day. It commemorates the day in 1882 when Robert Koch made the stunning announcement that he had been able to identify the causative agent for tuberculosis – the Tubercle bacilli.

wtbd_news_section

Tuberculosis is a disease that has dogged human beings from the earliest times. It has seen the rise and fall of empires, it has caused the rise and fall of empires, it had nearly been eradicated from the developed world thanks to better standards of living, only to find an ally in HIV and make its way back.

In 1882, when Koch discovered the agent, almost one in seven people affected were dying. Today the number has gone down but the burden has gone up. Almost exclusively limited to the developing nations in the 80s and 90s now thanks to HIV-TB co-infection, this has truly evolved into a global disease. Add to that the issue of emergence of multiple drug resistant strains and extensive drug resistant strains. A few months ago, the total drug resistant strain was located and it spread a little bit of panic amongst the medical professionals.

I want TB to be gone in my lifetime. I guess it seems like an uphill task, but the success of the Indian Directly Observer Short-course Therapy (DOTS) regimen instituted under the Revised National Tuberculosis Control Program (RNTCP) is inspiring. Public health has improved over the last few years and though the burden remains high, with diagnosis and cure rates well above the recommended targets, the RNTCP remains a success story for all public health professionals to emulate.

header

However, I must voice my concerns about the rising costs and low efficacy in treatment of XDR and MDR cases, especially the former. Given the low cure rates and the abysmal recurrence rates, and the sky high costs, the need to devise newer drug regimes and discover newer chemotherapeutic agents active against these resistant strains is of prime importance.

There is also the ethical dilemma about dealing with the total drug resistant strain bacteria. It goes without saying that there are no effective treatment for this strain today and hence, the dilemma. If they are treated with second or third line drugs, that is more for the purpose of satisfying our urge to do something rather than cure the patient. Also, the issue of leaving a possibly infectious source untreated is unacceptable. Given the toxicities associated with the second and third line drugs and the elevating costs and low chances of success, the dilemma is what to do. The issue of leaving the patients quarantined for an unlimited time period also seems unreasonable.

There are ethical and financial considerations that are tied into this disease. In India, in large segments of rural people, this is still viewed as a curse. Just the other day I read in a leading vernacular newspaper the tragic news of a mother with MDR TB living with her 5 day old child in a ward full of other MDR TB patients because her husband and in-laws would not take their grandchild in for fear of contracting the curse. The health officials were flummoxed as to the next step. The neonate is the one losing out in all this!

And although the BCG vaccine is given universally, its role in preventing pulmonary TB, the commonest variant, is minimal. It is supposed to give protection against hematogenous spread of the disease but has essentially no effect on the commonest variant. If the war against TB has to be escalated, the need of the hour is to design an effective vaccine. Chemotherapy is but a temporary measure, as the bugs will learn to gain resistance, especially in the developing nations where the number of defaulters are higher.


You Might Also Like :

Back to Featured Articles on Logo Paperblog

These articles might interest you :

  • Pineapple Pie

    Pineapple

    How are you all surviving these dog days of summer? I have discovered a sweet that will cool everyone down. Pineapple Pie. You can make it with canned... Read more

    The 22 July 2018 by   Kalamitykelli
    FOOD & DRINK, RECIPES
  • 10 Reasons To Market Yourself More Than A Great Idea

    Reasons Market Yourself More Than Great Idea

    Too many entrepreneurs I know still believe that that their great idea will carry the startup, and they may even minimize their own value, especially if they... Read more

    The 22 July 2018 by   Martin Zwilling
    BUSINESS, CAREER
  • In Praise of Liver: Falling in Love with a Widely Reviled Food

    Praise Liver: Falling Love with Widely Reviled Food

    Do you love liver? If you are like almost 50% of Anglo-Western populations, the answer is likely no. In fact, surveys in some countries - UK, US, Canada -... Read more

    The 22 July 2018 by   Dietdoctor
    DIET & WEIGHT, HEALTH, HEALTHY LIVING, MEDICINE
  • Infertility, PCOS and the IDM Program

    Infertility, PCOS Program

    Dr. Jason Fung: I was having a discussion with Megan Ramos the other day in our clinic, and she mentioned that yet another patient had gotten pregnant... Read more

    The 22 July 2018 by   Dietdoctor
    DIET & WEIGHT, HEALTH, HEALTHY LIVING, MEDICINE
  • Magdalene’s Day 2018

    Magdalene’s 2018

    Every year on her feast day, I honor St. Mary Magdalene; even though the Church does not officially recognize her as the patron of whores, she certainly is in... Read more

    The 22 July 2018 by   Maggiemcneill
    LOVE & SEX, SEXUALITY
  • Cops and Robbers

    Cops Robbers

    The deluge of GDPR emails has finally dried up, thank the Lord. For the uninitiated, GDPR stands for the General Data Protection Regulation 2018. Read more

    The 22 July 2018 by   Jackscott
    DIARIES, EXPAT, SELF EXPRESSION
  • Holy Grove and Ripple Music Announce the Completion of the Upcoming Album by...

    Holy Grove Ripple Music Announce Completion Upcoming Album Portland's Epic Heavy Doomers

    Ripple Music is thrilled to announce that Portland, Oregon, heavy rockers Holy Grove have just completed the recording of their second full-length, to be... Read more

    The 22 July 2018 by   Ripplemusic
    ENTERTAINMENT, MUSIC

Magazines