Wednesday September 19, 2018

How a phone call is saving lives of TB patients in India

The traditional medication adherence programme "Directly Observed Treatment" or "DOTS" involved the patients going to a healthcare centre where they ingest the medication in front of a health worker

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Tuberculosis
Representational image. IANS
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  • Can a phone call save lives?
  • A project called 99DOTS helps patients with Tuberculosis in India get medication
  • TB is one of the top 10 causes of deaths globally

In a world flooded with technological advancements, can a phone call save lives? This is happening as part of a project developed by software giant Microsoft in India.

The project, named “99DOTS”, which began in 2013 helps patients with Tuberculosis in India get medication adherence and monitoring via missed calls and SMSes.

From a modest pilot involving just 20 patients in early 2014, 99DOTS has enrolled over 93,000 patients in just four years, with 41,000 patients currently under treatment.

Rohingya Children
Tuberculosis causes lots of death every year. VOA

“99DOTS is a great example of such a project, where we’ve invented a very simple but unusually effective technology to solve a global health problem. And we are making this technology openly available to the global health community,” Sriram Rajamani, Managing Director, Microsoft Research India, said in a statement.

TB is one of the top 10 causes of deaths globally, with 10.4 million people falling ill with the disease and 1.7 million related deaths reported in 2016 alone. India leads the count in TB chart even though free and effective medications are available, according to the World Health Organisation.

Also Read: A new substance may help fight tuberculosis: study

“One of the biggest barriers to recovery from TB is medication adherence,” Bill Thies, senior Researcher at the Microsoft Researcher India, said in a statement.

“Patients have to take daily drugs for a full six months or else they do not fully recover, and are at risk of developing drug resistance.” However, “once patients start feeling better after a few weeks, it becomes very difficult to convince them to take toxic drugs for another five months – especially if patients have little or no understanding of germs and antibiotic resistance”, Thies rued.

This is where “99DOTS” project plays a significant role. In the project, each anti-TB blister pack is wrapped in a custom envelope, which hides a phone number behind the medication. When a patient dispenses his or her pills, they can see these hidden numbers. After taking daily medication, patients make a free call to the number.

A new substance may help fight tuberculosis: study
This helpline help patients get medication on time. Wikimedia Commons

The combination of the call and patient’s caller ID yields high confidence that the dose was “in-hand” and they took it, Thies said. The team also developed an SMS reminder system for patients. Missed doses trigger SMS notifications to care providers, who follow up with personal or phone-based counselling. The traditional medication adherence programme “Directly Observed Treatment” or “DOTS” involved the patients going to a healthcare centre where they ingest the medication in front of a health worker.

“99DOTS gives the patients the freedom and ownership of their treatment. They are able to take the medication wherever they are. It also provides them the privacy of not having to visit a health centre,” explained Andrew Cross who was earlier Programme Manager at Microsoft Research and teamed up with Thies to build up 99DOTS. IANS

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Now Comes a Non-Antibiotic Drug to Treat Tuberculosis

The researchers hope for clinical trials in humans up in four years

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Tuberculosis
Novel drug may offer treatment for TB. Pixabay

In a first, British scientists have developed a non-antibiotic drug that can one day successfully treat tuberculosis (TB) in humans.

The drug, developed by the University of Manchester, works by targeting Mycobacterium tuberculosis’ (Mtb) defences rather than the bacteria itself. It can also take out its increasingly commonly antibiotic resistant strains.

In the study, published in the Journal of Medicinal Chemistry, animals with acute and chronic TB infection were treated with the compound.

The findings showed that the compound does not kill the bacteria directly, but results in a significant reduction in the bacterial burden.

“For more than 60 years, the only weapon doctors have been able to use against TB is antibiotics. But resistance is becoming an increasingly worrying problem and the prolonged treatment is difficult and distressing for patients,” said Lydia Tabernero, Professor from the varsity.

“But by disabling this clandestine bacteria’s defences we’re thrilled to find a way that enhances the chances of the body’s immune system to do its job, and thus eliminate the pathogen,” Tabernero said.

Tuberculosis
Representational image. IANS

Mtb secretes molecules called Virulence Factors — the cell’s secret weapon — which block out the immune response to the infection, making it difficult to treat.

The team identified one Virulence Factor called MptpB as a suitable target, which when blocked allows white blood cells to kill Mtb in a more efficient way.

“The great thing about MptpB is that there’s nothing similar in humans – so our compound which blocks it is not toxic to the human cells,” Tabernero said.

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“Because the bacteria hasn’t been threatened directly, it is less likely to develop resistance against this new agent, and this will be a major advantage over current antibiotics, for which bacteria had already become resistant,” he explained.

The researchers hope for clinical trials in humans up in four years. (IANS)