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Indian healthcare providers and pharma companies speed up to combat TB as drug resistance concerns emerge

Nandita Vijay, Bengaluru
Friday, March 24, 2023, 08:00 Hrs  [IST]

Indian healthcare providers and pharma companies pace up their efforts with early detection and research for new medicines to combat the spread of tuberculosis as drug resistance concerns emerge.
TB is a significant public health threat, with an estimated 10 million annual cases. India shares the highest TB burden with 2.69 million cases and 4.5 lakh fatalities every year.

On the occasion of the World TB Day observed annually on March 24, this year’s theme is ‘Put a Full Stop on TB’. Medical experts and pharma industry see the need to research for new drugs and accurate point-of-care diagnostics.

According to Dr Arjun Kalyanpur, chief radiologist and founder CEO, Teleradiology Solutions, Radiology forms an important part of the diagnostic process for tuberculosis detection and control. Tuberculosis spreads through contact from patients who have the infection to healthy people. From the radiological perspective, the infectious stage of the disease has certain imaging correlates such as lung cavities containing infected pus or pneumonia. The detection of active pulmonary tuberculosis is by x-ray. Screening x-ray of the community is extremely important to detect patients who have the infection and are spreading it unknowingly.

We see that a tuberculosis control programme therefore requires a screening component whereby radiographic screening of the population is done in high-risk areas to detect such undiagnosed disease. The challenge with such mass screening programmes is that they result in a large number of x-rays which are difficult to get reported given the current shortage of radiologists. In such a scenario, both teleradiology and artificial intelligence play an important role, Dr Kalyanpur told Pharmabiz.

Teleradiology enables transfer of the x-rays to the location where the radiologist is available to report these artificial intelligence algorithms that detect the lung x-ray findings of TB can also help radiologists in efficiently reporting the large number of x-rays that such screening programmes generate. Having a mobile x-ray unit that travels to endemic areas coupled with teleradiology is a big step forward in TB detection and control. The future of TB control therefore lies in its early detection by mobile x-ray screening programmes supported by teleradiology and AI, he said.

Dr. Ambarish Joshi, sr. consultant, pulmonary & sleep medicine, Primus Superspeciality Hospital, New Delhi, said: TB is highly contagious, with people with active pulmonary TB potentially infecting 5-15 persons per year through close contact. Hence, treatment is the only way to cut this chain. To this end, the Union government is committed to provide high-quality evidence-based regimes under the banner of the Revised National Tuberculosis Programme.
However, combating TB is an arduous task due to multiple deep-rooted issues. This requires STOP technique: Stigma, treatment, outreach, prevention.

A study showed that over 2 lakh people lost to follow-up in the national TB programme after diagnosis because of fear of stigma. Patients feeling better skip or stop treatment, leading to drug resistance. At the community level, there is a connectivity deficit between the needy and the programmes curated for them, hindering contact with services. Poor application of preventive measures like cough etiquette, nutrition, health education, ventilation, and counselling fuels the spread of TB. Only addressing all these can help alleviate spread of TB, said Dr Joshi.


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