Mumbai: Initially, the pilot study was launched in the city to measure the prevalence of latent TB.
This signifies giant changes in TB control gameplan which until now focuses on active TB detection and treatment, and not so much on prevention.
People with latent TB carry bacteria but do not have symptoms and cannot infect others.
But up to 10% can develop to active TB if latent infection is left unexpected.
It is estimated that 350 million Indians tend to have latent TB and prevent fractions can make dents in the burden of new cases.
This study will be the first structured effort to understand its name Latent TB in Mumbai, said Dr.
Mangala Gomare, BMC executive health worker.
The risk of developing active TB from latent infection increases more than 25 times between contacts of TB patients who are confirmed bacteriologically.
In this study, close contact 125 TB patients who were just diagnosed would be traced and filtered.
Active TB infections will be ruled out in advance in contact, take a blood test (test of the release of interferon-gamma, called IGRA) which measures the reactivity of individual immune to TB bacteria will be carried out.
Contacts will begin in a preventive course of three to six months from isoniazid and rifapentine based on the findings of IGRA.
BMC and India shared NGOs will filter around 500 people, taking at least 4-5 high-risk contacts for each of the 125 positive cases.
Preventive TB (TPT) treatment, which exists nationally, has been limited to coverage until the recent and very low priority.
The survey will be the first step towards TPT improvement, which will see more funds, infrastructure and labor pumped in.
Until the beginning of this year, TPT was only offered to children under five years who have active TB cases at home, and people living with HIV.
Now, TPT has been extended to children in the top five and adult household contacts after active TB infection has been ruled out in it.
People who live with immune suppressing conditions will also be persuaded.
Dr.
Pranita Tipre, TB Mumbai officer, said this study would go further and analyze how many of which adhere to months preventive courses and document obstacles.
Although treating latent infections can stop developments to active TB almost 90%, there is a major compliance problem.
Individuals, who should be healthy, often drop out of school.
Pill load, which can range from 36-182 tablets, also acts as a reducer.
Dr.
Tanu Singhal, a child-infectious disease expert at Kokilaben Hospital, said preventive treatment was rarely suggested because of a low compliance and lack of consciousness among doctors.
“Most are not directed at thinking about prevention, so little offers it,” he said, adding that the guidelines also stated that it must be given to immunocompromenous people such as diabetics and patients with organs transplant, but it was hardly practiced.
Latent TB regimens also have other shortcomings: do not protect against repetitive exposures, which inhibit their use in the setting of high TB loads such as India.
“A strong prevention program will be important to achieve TB goals at the end of 2025,” he added.
TB Control Gameplan: Mumbai to focus on prevention
