Tuesday February 18, 2020

India’s Tuberculosis Deaths have Doubled in 1 Year, says WHO report

Tuberculosis is a treatable air-borne disease, but TB treatment reaches only 59 per cent of the estimated TB patients in India

Representational image. Flickr

October 27, 2016: India had double the number of estimated deaths by tuberculosis (TB) in 2015 — 480,000 deaths, up from 220,000 deaths in 2014 — because previous estimates were too low, according to the World Health Organisations Global Tuberculosis Report 2016.

India has 27 per cent of the world’s new TB cases — one of the biggest infectious disease killers in India. The country had 2.8 million new TB cases in 2015, up from 2.2 million cases in 2014, according to the WHO report.

As India accounts for a high number of worldwide TB cases, global estimates have also gone up from 9.6 million to 10.4 million, the report said.

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India also had a higher estimated number of patients with drug-resistant TB in 2015 — 79,000, 11 per cent more than the cases in 2014. About 2.5 per cent of new TB cases are resistant to rifampicin, or to both rifampicin and isoniazid — the two most commonly used anti-TB drugs — while 60 per cent of all previously treated TB cases were drug-resistant.

“The TB epidemic is larger than previously estimated, reflecting new surveillance and survey data from India,” the WHO report said. Evidence of low previous estimates includes “household surveys, a state-wide TB prevalence survey, studies of anti-TB drug sales in the private sector, notification data and new analysis of mortality data”, the report said.

[bctt tweet=”The private sector in India treats an estimated 2.2 million TB cases.” username=””]

More and more TB cases diagnosed and treated in the private sector have been registered with the government over the last two years. Until 2012, when the government made it mandatory for private doctors to report cases to the government, no government or private agency nationwide tracked how many patients were diagnosed or treated successfully in the private sector. The notification of private sector patients has gone up by nearly four times. India’s private sector notified 14.4 cases per 100,000 people in 2015, up from 3.1 in 2013, according to data from India’s national TB programme, the Revised National Tuberculosis Programme.

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The government also has a better estimate of the TB cases in the private sector because of a 2016 study published in the Lancet. The private sector in India treats an estimated 2.2 million TB cases, the study said, based on data from the sale of drugs containing rifampicin, the main anti-TB drug. The study further said that the cases in the private sector could be anything between 1.19 and 5.24 million cases in 2014.

Tuberculosis is a treatable air-borne disease, but TB treatment reaches only 59 per cent of the estimated TB patients in India, the report said.

“The government’s TB programme has done a better job than most other countries of the same size and scale of TB,” said Puneet Dewan, a senior programme officer for TB at the Bill and Melinda Gates Foundation, a private foundation that also funds TB control programmes in India. “But lots of patients are not under the government’s supervised programme,” he added.

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The 2016 WHO report only calculates the number of new TB cases in 2015, and does not calculate the total number of TB cases (old cases and new), known as the prevalence of TB, because the WHO is awaiting results from the national TB prevalence survey scheduled for 2017-2018, the report said.

Six countries — India, Indonesia, China, Nigeria, Pakistan and South Africa — accounted for 60 per cent of the new TB cases in the world. India, China and the Russian Federation accounted for 45 per cent of multi-drug resistant cases in the world. (IANS)

  • Antara

    Such a tragic news!

Next Story

Anti-TB Drugs May Not Be Effective in Preventing Reinfections, Says Study

The infection also accounted for death in 230,000 children (including children with HIV associated TB) in 2017

WHO will start working towards ending Tuberculosis
Dr. Simon Angelo (L) examines Iman Steven suffering from tuberculosis, held by her mother (R) at the hospital of Doctors Without Borders (MSF), June 15, 2016, at the Protection of Civilians (PoC) site in Malakal, South Sudan. VOA

Anti-tuberculosis (TB) drugs cause changes to gut microbiota and increase susceptibility to Mycobacterium tuberculosis (Mtb) — a major reason why current treatments are ineffective in preventing reinfections, say researchers.

The study showed that chronic use of antibiotics controls TB infection but also leads to disruption of gut microbiota. This, in turn, leads to the dysregulation of the immune system, causing reinfection.

“Anti-TB therapies have been incredibly efficient in controlling the TB epidemic by decreasing morbidity and mortality associated with Mtb,” said Irah King from the McGill University in Canada.

“This study provides a basis for novel therapeutic strategies exploiting the gut-lung axis in Mtb infection,” King added.

For the study, the researchers treated mice with the most commonly used anti-TB drugs — isoniazid, rifampicin and pyrazinamide — for a period of eight weeks.

The findings, published in the Mucosal Immunology journal, showed that while all three drugs significantly altered the composition of the mice’s gut microbiome, only mice treated with isoniazid combined with pyrazinamide showed an increase in vulnerability to Mtb infection due to a compromised gut microbiota.

The researchers transplanted faeces from mice that had been treated with anti-TB drugs (specifically isoniazid and pyrazinamide) into untreated mice prior to infection and showed that faecal transplant was sufficient to compromise immunity to Mtb.

A tuberculosis patient holds medicines at the Lal Bahadur Shastri Government Hospital at Ram Nagar in Varanasi, India, March 13, 2018. VOA

Further, the team found that after the anti-TB treatment, alveolar macrophages — a type of immune cell located in the airways of mice and humans — were compromised in their ability to kill Mtb.

“We need to do more research in order to understand how the microbiome affects alveolar macrophages because these cells are critical for controlling early TB infection,” King said.

“We also need to identify the molecular pathways involved in the gut-lung axis.”

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According to the World Health Organization, TB is one of the top 10 causes of death worldwide.

In 2017, 10 million people fell ill with TB, and 1.6 million died from the disease (including 0.3 million among people with HIV).

The infection also accounted for death in 230,000 children (including children with HIV associated TB) in 2017. (IANS)