Paediatric Fixed-Dose Combination For Children With TB
G.S. Paper 3
Causes of the widespread TB
Recent study by National TB Control Program have shown worrying results on large number of TB cases, particularly among children.
The Revised National TB Control Program carried out tests for TB in children in 9 cities.
Out of 76000 children tested, about 5500 have been diagnosed with TB.
9% of those diagnosed have MDR-TB which shows the silent spread of TB and how our health system is failing to diagnose the disease at an early stage among children as well as adults.
The limited study conduted shows that unfortunately the RNTCP guidelines are not followed correctly resulting in the silent spread of the disease.
In many cases in which children have been diagnosed with TB have found to be in close surroundings of the adults suffering from TB as well.
Delay in diagnosis results in people in contact with the patient to get infected as well.
As per the guidelines issued by WHO, all the contacts and specially children of a newly diagnosed pulmonary TB patient must be tested for the disease and if required should be put on treatment by RNTCP
Children below 6 years in the houehold of a newly diagnosed patient must be given the drug Isoniazid as a prophylactic even when they do not have the disease.
Fixed-dose combination (FDC) drugs that take into account the revised dosages for children were finally made available in late 2015. The FDCs are meant for treating children with drug-susceptible TB and cannot be used to treat children who require second-line drugs or who have MDR-TB. India has finally introduced FDCs in six States and hope to cover the remaining states by the end of this year.
Using the Xpert molecular diagnostic test to screen children with TB is a positive step and should be welcomed, but all the diagnosed children should be guaranteed paediatric FDCs.