Saturday October 20, 2018

India is Ground Zero for TB: Number of cases much higher than reported

The study published in Lancet found that in 2014, the private sector treated double the cases handled by government-run hospitals depicting the failing battle against TB

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TB Patient. Image Source: Wikimedia Commons.
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INDIA, September 5, 2016: : Ground zero of the global battle against one of humankind’s deadliest diseases, India could have between two and three times more Tuberculosis(TB) cases than currently assumed, said a recent paper released in ‘Lancet’, a medical journal.

The study found that in 2014, the private sector treated between 1.9 million and 5.34 million cases — or about double the cases handled by government-run hospitals.

Before this study, India was believed to have about 2.2 million TB cases, a quarter of the global TB burden, thus far estimated at about 6.3 million.

However, the private sector both helps and hinders TB treatment, the study implies.

Although standardised Tuberculosis treatment in India is delivered by the public sector, early diagnosis and treatment are hampered by the presence of a vast and unregulated private health-care sector, said the study, whose eight authors come from a variety of institutions, including London’s Imperial College, the Indian government, the World Health Organisation and the Bill and Melinda Gates Foundation, which funded the study.

“Poor diagnostic practices in this sector prolong Tuberculosis transmission by delaying diagnosis, whereas a general lack of counselling and support of treatment adherence hampers successful, relapse-free cure,” said the study. “Moreover, most cases treated in the private sector are never notified to public health authorities.”

Tuberculosis Diagram. Image Source: Wikimedia Commons.
Tuberculosis Diagram.
Image Source: Wikimedia Commons.

Analysing sales patterns of 189 drugs containing rifampicin — a key anti-TB formulation — over 2013 and 2014, the researchers estimated how many were sold to the private sector. In 2014, the WHO estimated that 800,000 TB patients escaped public-sector diagnosis, but these statistics were mostly compiled from expert opinion. So, the new study provides an empirical estimate that is independent of such opinion.

“This study illustrates the need to address the burden of Tuberculosis treated by the private sector and improve surveillance,” the researchers wrote, acknowledging the paper’s limitations, including the failure to capture TB patients who do not approach a doctor, use the informal sector or are being treated for multiple-drug resistance.

“This study also raises an urgent need to revise current estimates of Tuberculosis burden, informed by more systematic evidence relating to Tuberculosis management in the private sector,” the researchers wrote.

Although the incidence of TB in India has been declining, drug resistance and its interaction with other diseases, such as HIV, have slowed progress.

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Throughout history, TB has killed more humans than any conflict, disaster or disease known to mankind. In the 5th century, Greek philosopher Hippocrates advised doctors to stay away from TB patients, since there was no cure. In the 17th, it was called the great white plague of Europe, as it swept the continent, killing thousands over 200 years. In the 21st Century, it infects 10 million people every year, killing a fifth of those.

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TB bacteria have in-built armour, acids that protect them against the body’s cellular defenders. Most people infected with it have latent tuberculosis, where the bacteria are walled off in clumps by the cells of the immune system. Sometimes, the containment fails, particularly in people with weakened immune systems. If a drug doesn’t kill the bacteria completely, it becomes immune to that drug and can eventually overwhelm the immune system. (IANS)

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India Continues Engaging With USA Over H-1B Passport Issue

India is closely engaged with the US administration as well as the US Congress on this matter.

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As Trump proposes changes in H1-B visa, India continues to engage with US

India is continuing to engage with the US over the H-1B visa, largely availed of by Indian IT companies, after the Trump administration proposed changes to the programme, a senior official said on Thursday.

“It is a very important topic for us and that is the reason why we have time and again at various levels, we have taken up this matter with the US side,” External Affairs Ministry spokesperson Raveesh Kumar said in response to queries by journalists here.

Kumar said that most recently, the issue was raised during the first ever India-US 2+2 Ministerial Meeting held here last month that was attended by External Affairs Minister Sushma Swaraj, Defence Minister Nirmala Sitharaman, US Secretary of State Mike Pompeo and Defence Secretary Jim Mattis.

On Wednesday, the US Department of Homeland Security (DHS) said that the US Citizenship and Immigration Services (USCIS) plans to come out with its new proposal by January 2019.

India n Passport
It will also “revise the definition” of employment and employer-employee relationship to “better protect” US workers and wages Flickr

The DHS said it was also proposing to remove from its regulations certain H-4 spouses of H-1B non-immigrants as a class of aliens eligible for employment authorisation.

The move to end the rule could have an impact on more than 70,000 H-4 visa holders, who have work permits.

The H-4 visas are issued by the USCIS to immediate family members (spouse and children under 21 years of age) of the holders of H-1B visa.

The DHS said it will propose to revise the definition of speciality occupation to increase focus on obtaining the best and the brightest foreign nationals via the H-1B programme.

It will also “revise the definition” of employment and employer-employee relationship to “better protect” US workers and wages, the DHS said.

Donald Trump, India
President Donald Trump speaks about immigration alongside family members affected by crimes committed by undocumented immigrants, at the South Court Auditorium on the White House complex, June 22, 2018, in Washington, VOA

In his remarks on Thursday, Kumar said that India is closely engaged with the US administration as well as the US Congress on this matter.

Stating that there are certain bills which have been introduced, he, however, said that “it is important to note that none of these bills have been passed so far”.

“When we have engaged with the US, we have emphasised that our partnership which we have in the digital sphere have been mutually beneficial,” the spokesperson said.

Also Read: USA And Other Countries Pledge To Eradicate Illegal Wildlife Trade

“We have highlighted the role which has been played by the highly skilled Indian professionals who have actually contributed to the growth and development of the US economy,” he stated.

“And also they have helped the US to maintain a competitive edge in the world towards innovation and science and technology.” (IANS)