SPEAKING before participants of this year’s annual convention of the Philippine Coalition Against Tuberculosis or PhilCAT, Dr. Aamir Khan, an epidemiologist and executive director of Interactive Research and Development based in Karachi, Pakistan, stresses that even if health systems were able to find and instantly treat every new case of tuberculosis or TB, the epidemic would still not be stopped.
“People who are already infected will continue to become future TB disease cases and spread the disease further. Shrinking that reservoir of people who are infected with TB is the only way to stop the epidemic,” he reminds his audience.
He explains that aside from protecting people from exposure to TB bacteria, there should be a campaign to treat people who have been exposed to TB with preventive therapy.
An effective strategy, Khan explains, is to screen people who live or work in settings with a higher active TB exposure risk so that they can be treated and protect others from infection.
Among these individuals include those who have spent time with someone who has active TB disease; those who live or work in high-risk settings (for example: correctional facilities, long-term care facilities or nursing homes, and homeless shelters); healthcare workers who look after patients with increased risk for TB infection; as well as infants, children and adolescents who are exposed to adults who may be harboring the active form of TB.
Preventive therapy
After testing comes preventive therapy. “What we have successfully done in Karachi [Pakistan] in terms of patient compliance is to employ shorter treatment regimens to treat latent TB infection: Rifapentine and isoniazid once weekly dosing for three months was offered as an alternative to the usual six months of isoniazid as preventive treatment. Another is Rifampicin plus isoniazid daily for three months. These shorter regimens helped our patients adhere to their treatment and complete it,” reports Khan.
The good news according to Khan is that preventive therapy can significantly reduce the chance of people belonging to high-risk groups of becoming sick with active TB disease if they are infected.
He tells his audience that he looks forward to implementing a similar guidelines in the Philippines as they offer a number of opportunities, including simpler, shorter, preventive TB regimens, that will help reinvigorate TB prevention for high burden countries like the Philippines.
This year, PhilCAT is campaigning to strengthen a campaign to identify those who have latent TB infection and give them prompt treatment.