TUBERCULOSIS - SCIENCE

TUBERCULOSIS - SCIENCE

News: Indian Council of Medical Research (ICMR) has begun work on bringing in affordable, faster and easy-to-use testing technology for detection of tuberculosis (TB). 

 

What’s in the news?

  • The Council has invited Expressions of Interest (EOI) for undertaking ‘Transfer of Technology’ for the commercialisation of A CRISPR Cas based TB detection system for the detection of Mycobacterium TB. 
  • The system can detect the TB bacteria using DNA from a patient’s saliva for a very low cost, can identify the bacteria with preliminary symptoms, and test over 1,500 samples simultaneously within approximately two hours. 

 

What is Tuberculosis?

  • Tuberculosis (TB) is an infectious disease that most often affects the lungs and is caused by the bacteria Mycobacterium tuberculosis.  
  • It spreads through the air when infected people cough, sneeze or spit.
  • TB can manifest in two forms: Latent TB infection and active TB disease.
    • In latent TB infection, the bacteria are present in the body, but the immune system keeps them in check, and the person does not exhibit symptoms. 
    • However, the bacteria can become active later, leading to active TB disease, which is characterized by symptoms such as persistent cough, chest pain, weight loss, fatigue, and fever.
  • Symptoms: prolonged cough (sometimes with blood), chest pain, weakness, fatigue, weight loss, fever, night sweats.
    • The symptoms people get depend on where in the body TB becomes active. While TB usually affects the lungs, it also affects the kidneys, brain, spine and skin.
  • Treatment: Tuberculosis is preventable and curable.
    • Tuberculosis disease is treated with antibiotics. 
    • TB Vaccine: The Bacillus Calmette-Guérin (BCG) vaccine remains the only licensed vaccine against TB; it provides moderate protection against severe forms of TB (TB meningitis) in infants and young children.

 

India’s Burden of TB

  • India accounts for around 27% of TB cases worldwide – which is the world’s highest country-wise TB burden.
  • In India TB kills an estimated 480,000 people every year or over 1,400 patients every day. 
  • Additionally, the country also has more than a million ‘missing’ TB cases annually, which are not notified. 
  • India’s aim to eliminate TB by 2025. 

 

Challenges Faced by India in Eliminating TB

  • Diagnostics and Case Detection: The accurate and timely diagnosis of TB remains a challenge.
    • Some areas lack access to modern diagnostic tools, leading to reliance on older methods with limitations. 
  • Drug-resistant TB cases: India has a significant burden of drug-resistant TB, including multidrug-resistant TB (MDR-TB).
    • This type of TB is much harder to treat and requires more expensive, specialized drugs and a longer duration of treatment.
  • Poor primary health-care and infrastructure: In many parts of India, especially in rural and remote areas, there is limited access to healthcare facilities.
    • This can result in delayed diagnosis and treatment, allowing TB to spread within communities.
  • Stigma and Awareness: Stigma associated with TB can lead to delays in seeking healthcare, and lack of awareness about the disease may contribute to its persistence. 
  • Private Sector Engagement: A significant portion of healthcare services in India is provided by the private sector.
    • Coordinating efforts between the public and private sectors and ensuring standardized treatment protocols are crucial for effective TB control.
  • Treatment Adherence: TB treatment requires a prolonged course of antibiotics, and ensuring patient adherence to the full course is challenging. 
  • Vulnerable Populations: Certain populations, such as migrant workers, urban slum dwellers, and those living in crowded conditions, are at higher risk of TB.

 

Steps Taken by Government of India to Eliminate TB

  • Revised National Tuberculosis Control Program (RNTCP): The RNTCP, launched in 1997, was the flagship program to control TB in India.
    • The program has been continuously revised and strengthened over the years.
  • National Tuberculosis Elimination Program (NTEP): The Government of India has developed a National Strategic Plan (2017-25) for Ending TB in the country by 2025.
  • Pradhan Mantri TB Mukt Bharat Abhiyan (PMTBMBA): Launched in 2022 for community support to TB patients with the objective to provide people with TB with additional nutritional, diagnostic and vocational support.
  • Universal Drug Susceptibility Testing (DST): The government has scaled up efforts to provide universal access to drug susceptibility testing, helping to identify drug-resistant strains of TB early and tailor treatment accordingly.
    • Earlier, the patients were started on first line treatment and were tested for drug resistance only if the therapy did not work. 
  • Ni-kshay portal: An online Ni-kshay portal has been set up to track the notified TB cases.
  • New Drugs: Newer drugs such as Bedaquiline and Delamanid for the treatment of drug-resistant TB have been included in the government’s basket of drugs provided free TB patients. 
  • R&D for Treatment: Researchers have been studying shorter three- and four-month courses of anti-tubercular drugs, instead of the existing six-month therapy.
  • Vaccine Development: Trials are underway to test the effectiveness of a vaccine called Immuvac, which was initially developed to prevent leprosy, in preventing TB.
    • Researchers are also testing VPM1002, which is a recombinant form of the BCG vaccine modified to express the TB antigens better. 

Source: https://www.thehindu.com/sci-tech/health/in-major-breakthrough-icmr-develops-low-cost-tuberculosis-test/article68441244.ece#:~:text=%E2%80%9CICMR%20has%20developed%20a%20tech