The government has launched a new home-based drug-resistant
tuberculosis management for what officials say patient compliance and
reducing hospital burden.
The new treatment modality was initiated on Tuesday with the
introduction of a new WHO-approved diagnostic machine GeneXpert that
will identify the multi-drug resistant TB (MDR TB) within two hours.
It now takes two months to diagnose TB that does not respond to any
of the most effective antibiotics –Isoniazide and Rifampicin, and a
patient has to stay more than six months in hospital in its 20 to 24
months treatment period.
In the new home-based management system, according to National TB
Programme (NTP), an MDR TB patient can take drugs at home only after one
or two months of hospital stay if the sputum tested negative to the
organism. A trained team would ensure the medication at home.
Launching the new initiatives supported by USAID in Dhaka, Health and
Family Welfare Minister AFM Ruhal Haque said "it's a milestone" in MDR
TB management. USAID Bangladesh Mission Director Richard Greene handed
over a GeneXpert machine to the minister.
Tuberculosis, caused by the organism Mycobacterium tuberculosis, can
be fatal but is curable with a set of antibiotics, experts say.
Multi-drug resistant forms of TB developed because of inappropriate
or incomplete treatment, which is highly fatal and could pass on from
one individual to another.
The overall TB prevalence rate is 411 per 100,000 populations in
Bangladesh while NTP estimates 3,200 MDR TB with annual 1.56 percent new
cases.
The fatality rate of MDR TB is five times higher than the usual forms of TB – lung TB or otherwise.
According to British medical journal The Lancet it is increasing worldwide.
In the new policy, field staff will administer rest of the regimen of
drugs at home in a procedure WHO called DOTS (Directly Observed
Therapy, Short-course).
NTP's Line Director Dr Md Ashaque Husain said the new system would
benefit MDR TB patients as only 162 beds in two infectious diseases
hospitals in Dhaka and Chittagong have to grapple to mange patients.
"The two hospitals can only manage 400 such patients a year leaving many waited outside."
He said the new management would reduce hospital stay as well as
overall management costs and hospital acquired infections of those
immune-compromised TB patients. The rest of the treatment would continue
at home under close observation of outpatient MDR TB team and drugs
would be ensured by trained healthcare providers.
Husain, however, said it would be a challenge to form the team.
Speaking at the launching ceremony, the health minister asked for
close monitoring of the programme and suggested training of doctors for
'effective management' of MDR TB.
Studies show that people with weaker economic background – with a
monthly income of less than Tk 3,000 and with no education – are more at
risk of getting TB than others.
Dr Akramul Islam, head of Brac's health programme that oversaw
government's TB control strategy, told bdnews24.com that socio-economic
conditions are directly linked to tuberculosis.
He said England could control TB even 40 years before drugs were invented as its socio-economic condition improved.
"In the long run, you cannot control TB unless you contain poverty and ensure good living condition," he said.
Islam said they usually suspect a patient MDR TB if they do not
improve in two to five months after the treatment start. "Then we go for
MDR TB test."
According to a media release, USAID has invested approximately $ 30million in tuberculosis control since 2007.
News Source:
BDNews24