This year, Tamil Nadu is looking at expanding Tuberculosis (TB) preventive therapy to all districts.
Piloted in two districts — Pudukkottai and Tiruvallur — over the last seven to nine months, the initiative will toe the concept of “treat all” to cover household contacts of patients diagnosed with TB.
“When we are looking at the eradication of TB, a multi-pronged approach is essential. Offering preventive therapy is one such approach. This was piloted in Pudukkottai, Tiruvallur and some parts of Chennai and Kancheepuram. We found that it had good outcomes,” Asha Frederick, Additional Director and State TB Officer, said.
TB preventive therapy, she said, was offered to contacts and family members of pulmonary TB patients who had microbiologically confirmed the presence of bacteria in the sputum. Therapy was initiated after ruling out TB in them.
“TB preventive therapy is already in practice for children and persons living with HIV/AIDS. Microbiologically-positive TB patients will be spreading the infection to their family members. So, one of our priorities is to test the family contacts,” she added.
For the last nine months, TB preventive therapy was being piloted in Pudukkottai district, where 6,009 household contacts were tested. Of them, eight were diagnosed with TB. The therapy was initiated for 315 people. Many of them had completed treatment.
In Tiruvallur district, where the programme was rolled out in August last year, a total of 8,429 people were tested, of whom 18 were diagnosed with TB. A total of 587 household contacts were put on therapy, the official said.
While the two models of “test-and-treat” and “treat all” were being looked at, with the former being piloted in the two districts, the State TB Cell plans to toe the line of “treat all” for the expansion initiative. “This is based on the assumption that the infection will be there. This is very resource-intensive and challenging,” she observed.
For the preventive therapy, two treatment regimens are available — one for six months and another for three months, which comprises a combination therapy. Looking ahead at expanding the therapy to all districts, the State TB Cell has roped in Women Health Volunteers (WHV) of the Makkalai Thedi Maruthuvam scheme to function as treatment supporters/DOTS (Directly Observed Treatment Short-course) providers. The training of WHVs is under way and, till date, 82 of them have completed the Trainer of Trainers programme.
“We are also roping in TB champions, who are TB survivors, to serve as DOTS providers. We will be involving 485 TB champions through REACH (an NGO that works in the field of TB). WHVs, TB champions and Accredited Social Health Activists will be engaged in the initiative,” Dr. Asha Frederick said.
