WHO-endorsed test displays greater sensitivity in diagnosing bacterial load, and is being done for free

There are several scary numbers when it comes to tuberculosis — two deaths every three minutes in the country, being one. But what’s scarier is that even though every year, 85,000 children are diagnosed with TB under the Revised National Tuberculosis Programme, experts say the figure could be higher.

“At present, paediatric cases form seven per cent of the total number of cases under RNTCP. But the real figure could be 15 or 20 per cent of the total TB burden,” says Soumya Swaminathan, director, National Institute for Research in Tuberculosis.

To try and get ‘missed’ cases diagnosed, and to begin to study another scary prospect – the number of children with multi-drug resistant TB — a four-city project was launched in Chennai on Thursday.

Funded by USAID and facilitated by international NGO FIND, the three-month project will offer free testing for children between the ages of 0 and 14 in both the private and public sector. Those diagnosed can avail of treatment under RNTCP.

“Any paediatrician can send in a sample for testing, and we will send back results within two hours,” said an official of FIND. Parents can also directly approach the National Institute for Research in Tuberculosis, the project’s centre in Chennai.

GeneXpert, a WHO-endorsed test, will be used for diagnosis. TB diagnosis in children is generally challenging as it is hard to get a sputum sample — required for the conventional test —and even if a sample is obtained, the bacterial load in it may be too low for a diagnosis. GeneXpert though, has greater sensitivity, and studies have shown its diagnostic yield is higher,” says Dr. Swaminathan.

There is a tendency among many to avoid or delay treatment for medical conditions. And then, rush to a doctor when complications arise. This holds true for gall bladder stones, a common gastrointestinal disease. When doctors tell patients that surgery is the only option for ‘gall stones’, some accept immediately, while some choose not getting treated at all, and end up with a complication due to the stone.

S.M. Chandramohan, professor and head, Department of Surgical Gastroenterology, Rajiv Gandhi Government General Hospital says mostly, the problem of gall stones is only due to waiting without proper treatment.

“These gall stones are either detected incidentally during a routine check-up or while being evaluated for abdominal pain, fever or jaundice,” he says.

So what causes stones in the gall bladder? The commonest cause is cholesterol, then infections or a combination of both. The typical symptom could be “biliary colic’ – colicky pain in the right side of the upper abdomen, he explains.

The right treatment is to remove the gall stones along with the gall bladder – cholecystectomy. This is done laparoscopically now, he adds.

Many ask if these stones can be dissolved by medicines. “A majority of the small stones in Indian population are pigment stones and they do not dissolve with medicines,” he says.

If left untreated, there are several complications ahead. The stones can slip into the bile duct and produce jaundice. It could cause inflammation and infection of the pancreas, Dr. Chandramohan adds.

He points out that with key hole surgery, patients can get back to their routine life within days.

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