On Mar 20, 2019, World Health Organization (WHO) issued guidelines "WHO Consolidated Guidelines on Drug- Resistant Tuberculosis Treatment" (the 'Guidelines') to accelerate the treatment of tuberculosis for proper eradication of the multidrug resistant TB (MDR-TB) as the Guidelines recommend the complete use of oral regimens to treat the patients with multidrug resistant TB (MDR-TB). According to the reports, the strains of drug resistance (DR-TB) Tuberculosis are more difficult to treat than drug-susceptible ones, hence there was a critical need for the policy for the treatment and care of patients with DR-TB.
The main feature of the WHO guidance for the proper eradication multidrug resistant TB (MDR-TB) are:
- The consolidated guidelines include policy recommendations on treatment regimens for isoniazid-resistant TB (Hr-TB) and MDR/RR-TB, including longer and shorter regimens, culture monitoring of patients on treatment, the timing of antiretroviral therapy (ART) in MDR/RR-TB patients infected with the human immunodeficiency virus (HIV), and use of surgery for patients receiving MDR-TB treatment, and optimal models of patient support and care.
- A dashboard to help countries know more about their own epidemics through real-time monitoring – by moving to electronic TB surveillance systems.
- A guide for effective prioritization of planning and implementation of impactful TB interventions based on analyses of patient pathways in accessing care.
- New WHO guidelines on infection control and preventive treatment for latent TB infection
- A civil society task force to ensure effective and meaningful civil society engagement
In India, the government is committed to elimination of TB in the country by 2025. On the occasion of 'World TB Day 2019'1 the health ministry has stressed on the importance of more sensitive and responsive doctors, paramedics, frontline health workers and community partners, while dealing with TB patients. The ministry also announced the significant progress in TB eradication programme, as India is now closest ever to covering all TB cases with 21.5 lakh new TB patients notified in 2018.
The health ministry also announced that a total of 15 lakh patients have been initiated in the Fixed Dose Combination (FDC) regime till date. TB forums at various levels in the states have been formed to remove stigma and to create awareness about the symptoms of the disease and the free treatment available at the government health facilities. 1180 CBNAAT labs have been made operational throughout the country, along with 4 lakh treatment support centres at the village level. These efforts have resulted in increased from 25% to 83% in the treatment success rates (2017-2018), and the TB prevalence rates have come down from 29% to 4%.
The treatment of DR-TB and MDR-TB stains has raised a biggest concern worldwide. Hence, These guidance will help the countries all around the world to accelerate progress and act on the high-level commitments made in the first-ever UN High Level Meeting on TB last September, especially communities facing socio-economic challenges, those working and living in high-risk settings, the poorest and marginalized.
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