Advanced technology machine for better TB diagnosis

The National Tuberculosis Control Program (NTCP) under the Department of Public Health has introduced Line Probe Assay (LPA), a molecular based rapid diagnostic of Multi-Drug Resistant Tuberculosis (MDR-TB) by Health Minister, Tandin Wangchuk, at JDWNR Hospital on March 21 in Thimphu.
The Ministry of Health (MoH) introduced the LPA, an advanced technology, to rapidly diagnose Multi-Drug Resistant Tuberculosis (MDR-TB) at the Public Health Laboratory. LPA can diagnose MDR-TB within 3 days from fresh sputum samples as compared to conventional methods which takes around 3-4 months. This will enable early diagnosis of MDR-TB and prompt initiation of treatment, thereby, reducing transmission of the disease in the community which is key area for TB control.
MDR-TB is a severe form of TB that does not respond to the effective first line TB drugs, and is mainly caused by inadequate and non-compliance to treatment. It is difficult to manage since the drugs can cause severe side effects, and the treatment could last for more than 24 months. The treatment is also very expensive and cost around Nu 1, 80,000 per patient, which is 100 times more than the cost of treating normal TB cases. Increasing MDR-TB cases are being diagnosed every year, and 49 MDR-TB cases were diagnosed and enrolled on treatment in 2013.
The Health Minister, Tandin Wangchuk, said, “We have to make sure that medicines
should be taken in time and make sure that it is our responsibility to take care of the TB patients and join hands to solve the TB problem.”
“Educating people is very important to prevent TB. MoH should think of other measures to make awareness to people about the TB, like introducing road shows, etc. TB rate is alarming when patient are sent to their respective home, so we should not wait for our infrastructure to develop, we have to go ahead, if patient have to keep in isolation then we have many space, and my immediate request is we should sort the space to keep the TB patient.” Lyonpo Tandin Wangchuk said.
The Director General, MoH, Dr Dorji Wangchuk said the ministry will be introducing sticker system to track the progress of the patients by physicians. The ministry will also be providing mobile vouchers to all the TB in-charge to remain in touch with TB patients, reminding them to take the drugs on time.
The Ministry of Health has set targets to improve MDR-TB case detection and achieve treatment success rate of 75% by 2016, and to improve detection of TB/ HIV co-infections to register at least 80% of estimated co-infected individuals by end of 2016.
Some of the challenges faced by MoH are the increase in the number of MDR-TB cases, shortage of human resources, lack of adequate financial resources and community participation.
According to MoH, the total notified TB cases in 2013 were 1,115 and total TB in children was 58, of which 20 are new smear positive.

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