Press release from Business Wire India
Source: Global Health Advocates India
Monday, November 14, 2011 03:21 PM IST (09:51 AM GMT)
Editors: General: Consumer interest, Economy, People, Social issues; Business: Healthcare, biotechnology & pharmaceutical; Healthcare
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Government of India ,TB Experts Discuss Integration of TB Screening for Pediatric TB in Child Health Programmes, On Children's Day at Seminar Organised by Global Health Advocates India
New Delhi, Delhi, India, Monday, November 14, 2011 -- (Business Wire India) -- Lack of Standardized Treatment Among Private Practitioners Leading to Life Threatening Multiple drug Resistance and Extreme Drug Resistant Pediatric Tb, Experts Recommend Ban on OTC Sale of Second line of Treatment Drugs used for treating Drug Resistant TB,DDG TB Control says it can one of the Regulatory Options to Consider to Restrict the OTC Sale of Second Line of Drugs .
Senior Government officials from the Central TB Control Division, Government of India, today heard strong recommendations from pediatric TB experts,on screening for TB to be done at the child health programme level, for timely detection of children living with TB.
Speaking at the function, Ms. Rashmi Singh, IAS, Executive Director, National Mission On Empowerment of Women, Ministry of Women and Child Development , Government of India , said that early diagnosis is critical and there is a lot of apathy even among the community when it comes to timely treatment for women and children. She also recommended a multi - pronged approach to fighting pediatric TB pointing out that," Can any one strategy work in a segmented manner. We need to work together,no one Ministry or NGO can tackle the issue" . Ms. Singh also highlighted the role of personalised model of communication and said that the Anganwadi workers and ANMs( Auxillary Nurse Midwives) are being trained to look out for signs of Pediatric TB to ensure early diagnosis of TB.
Adressing a gathering of TB experts and parents of children living with TB, Dr Ashok Kumar, Deputy Director General, Central TB Control Division, said that cases of drug resistance are rising due to many reasons. These include not coming in early enough for treatment, trying multiple drug regimes,not completing the treatment and going to different practitioners. He said that there is a need to restrict the sale of second line of drugs used for treating drug resistant TB and said that regulatory mechanisms like banning the OTC sale of the second line of drugs is one of the options to consider.Giving data, Dr . Kumar said that 12 to 17 percent of all total TB retreatment cases are of drug resistant TB.
He was speaking at a seminar called, "A STEP TOWARDS ELIMINATION- PEDIATRIC TB' , organised by Global Health Advocates(GHA) India . GHA India runs The Advocacy to Control Tuberculosis Internationally (ACTION) project, an international partnership of advocacy organisations working in 7 countries to mobilize political will and resources to treat and prevent the spread of tuberculosis (TB). Dr. Kumar also released a documentary on paediatric TB by GHA India titled, 'Not a Toy Story-The Reality of Childhood TB'.
Globally every 5 minutes, a child dies from TB and 1 million children suffer from this disease every year. Elaborating on the challenge ,Dr. K S Sachdeva, Senior Chief Medical Officer , Central TB Division , said that in 2010 there were 90, 190 cases registered under the Revised National TB Control Programme. Dr. Sachdeva emphasised the importance of standardised drug treatment and strict pharma regulations by national health authorities for the sale of second line of drugs. He also made a case for innovative delivery methods to make it easier for children to take the medicine.
Giving a moving testimony regarding her experience at the seminar, Geeta( name changed) , parent of two children living with XDR TB( Extreme Drug Resistance ) from Amristar , Punjab said that she had to mortgague her house to treat her children even though treatment is free under DOTS Plus. She also said that school teachers treated her young children with hatred because they had TB , pointing out that stigma still exists regarding this disease.
Dr. Sapna Naveen, (Advocacy Officer) Global Health Advocates India said," TB screening at the Child Health Programme level would greatly help in early detection, diagnosis and treatment of a curable disease. TB is highly stigmatized with considerable discrimination to sufferers. The grim reality is that TB is depriving children of many of their human rights that includes health and education. Not only do they directly suffer as they are very vulnerable to transmission from adults in the household who have TB, but they are also vulnerable to becoming victims of child labour. Studies (Source : Socio economic dimension of TB, TRC) have shown that 20% of the children had to take up employment in order to supplement income if the father has TB."
India has the highest TB burden in the world with an estimated 1.8 million new cases every year. In high-burden settings children can make up as much as 20% of incident cases of active tuberculosis (Source: RNTCP). The latest data shows that in 5 States and Union Territories, between 12 and 18 percent of the total new TB cases are of Pediatric TB. These states are: Mizoram, Kerala, Puducherry, Delhi and Chandigarh (Source: RNTCP 1st Quarterly Report 2011).
The biggest treatment challenge facing Pediatric TB is the issue of drug resistance which is life threatening. Proper guidelines incorporating DOTS and DOTS Plus( for treating MDR TB) are implemented for the management of Pediatric TB and Pediatric Multi-Drug -Resistance( MDR) TB . These provide free diagnosis and standardized treatment regimens given to children under direct observation, but the guidelines are not always followed by private practitioners leading to multiple and extreme drug resistance. Speaking on the issue , Dr. Sangeeta Sharma, HoD of Pediatric Division, Lala Ram Swarup Institute of Tuberculosis and Respiratory Diseases, the core expert member for the formulation of guidelines on Pediatric TB for the Government of India's Revised National TB Control Programme, said that," We have proper DOTS and DOTS Plus guidelines available for children. For Drug Resistant TB, we have divided children into two weight bands - 15 to 25 kgs and 26-45 kgs and we have started providing full course of MDR management free to the children throughout the country and the program is being implemented step by step. The drugs are toxic but they take their own time and it's not a regimen where you can stop in say a month or 2 months. It needs to be given for full 24 months . Non compliance on the part of the patient or frequent regimen change and different combinations leads to the problem of what we are now facing as XDR TB ."
Dr Sharma also recommended restricting the availability of second line of drugs saying that," We need to limit the use of second line drugs. They are freely available across the counters in the chemist shops. This needs to be banned because otherwise we are sitting on a big time bomb. We have already reached the stage of XDR or Extreme Drug Resistance in children. But if we do not limit the use of second line drugs we are looking at something like X n DR , a totally incurable ,deathly state. "
Children in India are also particularly vulnerable due to rampant malnutrition. As per the National Family Health Survey III, an estimated 48 percent of the children in India below 5 years are chronically malnourished. The association between TB and malnutrition has long been known. TB makes malnutrition worse and malnutrition weakens immunity, thereby increasing the likelihood that latent TB will develop into active disease.
Lack of effective vaccines for children between the age of 5 and 10 is another issue that is leading to prevention of TB among children. Other suggestions made at the seminar include Priority by the policy makers and government for children to increase and improve nutritional status thereby preventing severe forms of the disease with an emphasis on micro nutrients supplementation, mandatory and effective infection control measures in public health facilities and pediatric OPDs to ensure interruption of transmission and enabling and accelerating food security measures for children to combat TB.
About GHA India
Global Health Advocates (GHA) India is a non-governmental organization that focuses on engaging all sections of society to fight diseases that disproportionately affect people living in poverty, and are also causes of people living in poverty. In particular, Global Health Advocates India works towards the formulation and implementation of effective public policies to fight disease and ill health in India. GHA India runs The Advocacy to Control Tuberculosis Internationally (ACTION) project, an international partnership of advocacy organisations working in 7 countries to mobilize political will and resources to treat and prevent the spread of tuberculosis (TB), a global disease that kills one person every 20 seconds.
CONTACT DETAILS
Paarul R. Chand, Media Coordinator, Global Health Advocates India, +91 9811426392, paarul@brightlitecommunications.com/ paarulchand9@gmail.com
KEYWORDS
CONSUMER, ECONOMY, PEOPLE, SOCIAL, HEALTHCARE, HEALTHCARE
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