Hope for patients suffering from multi drug resistant TB

Tuyeimo Haidula, CNS Correspondent, Namibia
Patients suffering from multi drug resistant TB (MDR-TB) may have the  likelihood of a higher cure success rate after the World Health Organization approved a new treatment regimen for it. The new WHO approved treatment is more patient friendly and aims to speed up diagnosis and improve treatment outcomes for MDR-TB in a shorter and cheaper way.

It would cost a U$1000 per patient for the new treatment which is less expensive than the current regimen, and also much shorter, taking 9 to 12 months to complete against the current 24-month long treatment.

During a webinar organised by Citizen News Services last week, Dr I D Rusen, Senior Vice President, Research and Development at the International Union Against Tuberculosis and Lung Diseases, said the current MDR-TB treatments are lengthy and often difficult to tolerate due to severe side effects. Dr Rusen said that WHO estimates that approximately 480,000 new MDR-TB cases are recorded every year globally. Of this number, only a quarter of the estimated cases are detected and put on treatment. “Of reported MDR-TB patients treated only 50% are treated successfully. Currently recommended treatments are lengthy and often difficult to tolerate,” he said.

Dr Rusen also informed that the new treatment regimen involves daily dose of Kanamycin, Isoniazid, and Prothionamide in the intensive phase carried out in the first 4 months, and clofazimine, gatifloxacin, ethambutol and pyrazinamide for all the 9 months. Kanamycin is given three times a week in the 4th month and the intensive four-month phase can be extended to 6 months. Dr Rusen said that the study which took place in Bangladesh involving 515 patients on the 9 month regimen, showed a cure rate of 82.1%.

“In another cohort study of 1000 patients on a modified Bangladesh regimen in West Africa, interim analysis of 408 patients has demonstrated similar treatment success rate. There are numerous other clinical research studies underway,” he said. Dr Fuad Mirzayev Medical Officer at WHO Global TB Programme, said that a shorter regimen is recommended with clofazimine as core second line medicine and PAS as additional one.

The new MDR-TB treatment is recommended for all patients with rifampicin resistant (RR) TB, regardless if isoniazid resistance is confirmed or not. Mirzayev said that recommendations also apply to the treatment of children with MDR-TB. “It can also be used for adults and people living with HIV suffering from pulmonary MDR-TB, but is not recommended for patients with extra pulmonary TB and in pregnant women,” he said. Meanwhile, a 2014–15 report released by the Ministry of Health on National TB and Leprosy programme shows that Namibia remains among the top 5 countries in the world with the highest per capita TB disease burden.

The number of TB cases diagnosed and treated in Namibia has maintained a downward trend from 16,156 cases in 2004 to 9,882 cases in 2014, representing a 39% decline during this period. A total of 137 cases of MDR-TB were reported in 2014, of which 6 were extensively drug resistant TB (XDR-TB) This signifies a slight decline in reported MDR-TB cases from 174 reported the previous year. The number of reported cases of rifampicin-resistant TB diagnosed using the Gene Xpert increased from 89 cases in 2013 to 199 cases in 2014. Last year Namibia’s Health Minister Bernard Haufiku reminded Namibians that it is each and everyone's collective responsibility to reach out to every TB patient in the country.

WHO’s representative in Namibia, Monir Islam, applauded the country for its significant progress in reducing the burden of TB, saying that there has been a consistent decline in the number of TB cases and treatment success rate of 85% has been maintained the over the past few years. Surely, the new shorter and cheaper treatment regimens will help in further increasing cure rates for MDR-TB patients.

Tuyeimo Haidula, Citizen News Service - CNS
June 30, 2016

No comments:

Post a Comment