Paediatric Fixed-Dose Combination For Children With TB

 

Relevancy

  • G.S. Paper 3
  • Current situation
  • Causes of the widespread TB
  • WHO recommendations

Recently

  • Recent study by National TB Control Program have shown worrying results on large number of TB cases, particularly among children.

Current Situation

  • 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.

Causes

  • 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.

WHO Recommendations

  • 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.

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