The Brihanmumbai Municipal Corporation plans to diagnose and treat people with latent tuberculosis (TB) infections in an attempt to curb the spread of the disease in Mumbai. By the end of the year, pilots will be conducted in selected wards with a high occurrence of TB and poor living conditions.
“India is not an ideal place for tackling latent TB due to the high burden of the disease. However, we want to target only the close contacts of drug-resistant patients who may have a latent infection and can become active at any time,” said executive health officer Dr. Padmaja Keskar, at the unveiling of the TB Free Mumbai Plan 2019-2025 on Wednesday.
According to Dr. Keskar, the plan mainly consists of technical guidance for health staff. “We will put a lot of focus on active case finding. A mobile X-ray van will also be deployed. Trials for the new drug Delamanid that will commence soon,” said Dr. Keskar. The latent TB diagnosis and treatment will take some time, she said.
Most people who are exposed to the TB bacteria manage to contain it with their immune defence system. However, in some people, the bacteria remains in the body in a latent form and may get activated at any point of time, causing the disease. A 2015 paper published in Lung India said Latent TB Infection (LTBI) screening must be restricted to specific high-risk populations in India, where the benefits of LTBI treatment outweigh the risks.
Vaccine trial at Sewri hospital
Dr. Keskar also said a trial for a preventive TB vaccine will start at the Sewri TB Hospital by September. The vaccine will be for close contacts of TB patients who are at high risk of contracting the disease. She said the case notification of TB has improved from 269 per one lakh to 395 per one lakh between 2013 and 2018. “Our new plan is technical guidance for all our health staff to ensure we achieve the TB-free target by 2025,” she said.
