India’s Journey Towards Ending Tuberculosis (#EndTB)

Sub: Sci

Sec: Health

Why in News

Tuberculosis (TB) remains a significant public health challenge globally. According to the World Health Organization’s (WHO) Global Tuberculosis Report 2024, TB continues to be the leading infectious disease killer worldwide. India, contributing to 26% of global TB cases, has pledged to eliminate TB by 2025, five years ahead of the global target of 2030.

About Extrapulmonary Tuberculosis (EPTB):

A form of tuberculosis where the infection occurs outside the lungs, affecting other organs and tissues.
EPTB accounts for approximately 15–20% of all active TB cases; this proportion increases to over 50% in individuals with HIV.
More common in immunocompromised individuals, such as those with HIV, and in young children.
Sites of Infection:
- Tuberculous lymphadenitis (scrofula) is the most frequent form of EPTB, characterized by swollen lymph nodes, typically in the neck.
- Tuberculous pleurisy involves infection of the pleural space, leading to pleural effusion.
- Central Nervous System: Includes tuberculous meningitis, which affects the membranes covering the brain and spinal cord.
- Skeletal System: Pott’s disease refers to TB infection of the spine, leading to vertebral damage.
- Genitourinary System: Involves organs such as the kidneys and reproductive organs; for example, genitourinary tuberculosis.
Diagnostic Tools:
- Biopsy and Histopathology: Tissue samples can reveal granulomas indicative of TB.
- Molecular Tests: Polymerase chain reaction (PCR) assays detect Mycobacterium tuberculosis DNA.
- Imaging: X-rays, CT scans, or MRIs help identify the extent and location of infection.
Typically involves a combination of first-line anti-TB drugs (isoniazid, rifampicin, ethambutol, and pyrazinamide) for a minimum of six months.

Cartridge-Based Nucleic Acid Amplification Testing (CBNAAT):

A rapid molecular diagnostic test to detect Mycobacterium tuberculosis (MTB) and its resistance to rifampicin, a key TB drug.
Based on Nucleic Acid Amplification Test (NAAT), using GeneXpert machines.
Provides results in under 2 hours.
Can detect TB even in cases of low bacterial load.
Minimal manual intervention reduces human error.
Detects both pulmonary and extrapulmonary TB.
Identifies rifampicin resistance.
Effective in diagnosing TB in HIV-positive patients where smear microscopy has limitations.
Widely implemented under the National Tuberculosis Elimination Program (NTEP).

National Tuberculosis Elimination Program (NTEP):

The National Tuberculosis Elimination Programme (NTEP) – Aims to strategically reduce TB burden in India by 2025.
It was previously known as Revised National Tuberculosis Control Programme (RNTCP).
The government reached over a billion people in 632 districts/reporting units.
The National Strategic Plan for TB Elimination – It was launched to achieve the target of ending TB by 2025 in a mission mode.
It is a multi-pronged approach which aims to detect all TB patients with an emphasis on reaching TB patients seeking care from private providers and undiagnosed TB in high-risk populations