New technology shortens TB treatment time

Mar 22, 2018 News

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• as Ministry advances patient-centred care and prevention

With the advent of new technology, the treatment regimen for tuberculosis [TB] now spans a period of nine month, down from two years. This is according to local PAHO/WHO Representative [PWR], Dr. William Adu Krow, who at a recent forum informed that this new technology has been introduced at the National Public Health Reference Laboratory [NPHRL].

Explaining the process, Dr. Adu-Krow said the new technique used for diagnosis and cultures in patients with multi-drug resistant strain of the infectious TB disease “is decisive to stop the increase of cases.”

While the PWR reiterated commitment to help Guyana combat the infectious ailment, he stressed the need for more collaboration locally. In fact, he disclosed that a call in this regard was made to all Representatives by Dr. Tedros Adhanom Ghebreyesus, Director General of PAHO/WHO.

Dr. Adu Krow in his deliberations recalled that in the fight to put the deadly HIV/AIDS pandemic on the global agenda, civil societies were in the vanguard and among other things, took legal action against many tardy administrations as the disease ravaged populations, especially in poor countries.

Here in Guyana, he observed that the mortality rate in Guyana has been slightly reduced in the last four years, and cases of co-infection, TB/HIV explain more that 40 percent of the deaths. But Guyana is still seven years behind the global agenda of ending TB by 2030.

Although TB infections have been declining in Guyana, Dr. Adu Krow said that, “the incidence rate still is over 70 out of 100,000 and a progressive increase of MDR TB [multi-drug resistant TB] has been emerging from 2015, 2016 and 2017 with five, 10 and 15 cases, which imposes a new challenge.”

Internationally, the nations of the world are aiming for a 75 percent reduction in tuberculosis deaths when compared with the figures of 2015. The countries have also agreed to a 50 percent fall in tuberculosis incidence rate, which is less than 55 tuberculosis cases per 100,000 populations. On the agenda for achievement by 2025, is ensuring no affected families face catastrophic costs due to tuberculosis.

To achieve this global three-point covenant, Dr. Adu-Krow said countries have to follow WHO’s example and pursue integrated, patient-centred care and prevention; bold policies and supportive systems and intensified research and innovation.

Guyana will join the rest of the world on Saturday to observe World Tuberculosis Day under the theme, ‘Wanted: Leaders for a TB-free world’.

The theme focuses on building on the global agreement to end TB at political levels with Heads of States and Ministers. But it also envisages cooperation at all levels, including community leaders, TB patients, religious leaders, civil society members, health-care providers and non-governmental organisations [NGOs].

On Tuesday, the Public Health Ministry unveiled its revised ‘National Guidelines for the Prevention, Treatment, Care and Control; of Tuberculosis, which “is a powerful tool against any form of TB,” according to Dr. Adu-Krow who said the strategy should be implemented in the public and private health services, with emphasis on primary health care, clinical sites and National Institutions.

Fifty local doctors from the 10 Administrative Regions participated in the three-day programme which is set to end today. “The updated Guidelines are coming in a moment that the Ministry of Public Health is acquiring 4 GenExpert equipment for diagnosis of MDR\TB and primary cases, expanding the coverage to the regions and reducing the lag time between the test and the result, that is very necessary to start treatment as soon as possible and the epidemiologic investigation of contacts and risk groups related to the patients, and if necessary, chemoprophylaxis,” the PAHO/WHO official said.

Minister within the Public Health Ministry, Dr. Karen Cummings, who also addressed Tuesday’s launch of the revised TB blueprint, noted that the effort is in keeping with international guideline, recommendations and those tailored for Guyana’s needs.

“It includes a new algorithm for the provision of Isoniazid Preventative Therapy for people living with HIV, updated laboratory capabilities for TB cultures, and drug sensitivity testing with the Gene-xpert machine and Bactec MGIT. It also encapsulates the new Short Course Regimen for the treatment of multi-drug resistant-TB, new formulations for the management of children with TB and new case definitions and classifications for the reporting of TB,” Minister Cummings said.

She also praised the improved document predicting the manual will “contribute to improved care and outcomes of patients infected with TB and other relevant co-morbidities [and] if followed in a conscientious manner, the guidelines will improve early detection for TB and help to curb the emergence of new drug resistant-TB in Guyana.”

Globally, some 53 million lives were saved through effective diagnosis and treatment of tuberculosis between 2000 and 2016. Meanwhile, 490,000 persons developed multidrug-resistant TB in the world in 2016 while globally an average of US$2.3 billion is needed annually to help implement existing TB interventions. “In other words, ending TB is a big challenge,” Dr. Adu-Krow admitted.

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