TB PREVENTIVE THERAPY- A PROVEN WAY TO STRENGTHEN TUBERCULOSIS CARE

 

PERSISTENT ADVANCEMENT- A PROVEN WAY TO STRENGTHEN TUBERCULOSIS CARE.

 

TB Preventive Therapy

 

While the severity of tuberculosis should not be underestimated—it is the second deadliest infectious disease after COVID-19 and the thirteenth leading cause of death worldwide—there is cause for optimism: Innovative screening, diagnosis, and treatment tools and health systems are paving the way for more affordable, efficient, and effective screening, diagnosis, and treatment. Due to the disruption of essential TB care during the COVID-19 pandemic, tuberculosis (TB) deaths are increasing for the first time in ten years.

"Innovation is critical for progress," says Dr. Sarmad Wahaaj, Program Director Provincial TB Control Program Punjab. “"The Provincial Tuberculosis Control Program, in collaboration with the National Tuberculosis Control Program, is constantly adapting and upgrading our methods to meet current TB challenges, which has been critical." in reducing TB infections, improving care standards, and building better health systems for a TB Free Pakistan as per Pakistan END TB Strategy. “

 DEVELOPMENT ACROSS THE HEALTH SYSTEM 

Because a single person infected with tuberculosis can infect up to 20 healthy people, communities must have access to high-quality health care that can reduce the spread of TB-related infection and death. PTP along with different partners has been successful in facilitating the following methods for the control of Tuberculosis. 

• SUCCESSFUL INTEGRATION OF THE PRIVATE SECTOR

Pakistan, the fifth-highest disease burden country in the world, has overburdened public health care facilities, so 75 percent of tuberculosis patients seek care in the private sector. However, missed and delayed diagnosis, gaps in care quality, and a high financial burden made private-sector TB treatment out of reach for many, fueling the transmission of TB across the country.

Recognizing this problem, the National Tuberculosis Control Program, in collaboration with the Provincial Tuberculosis Control Program, developed the Public-Private Mix Model (PPM), a game-changing model that has dramatically improved the efficiency and quality of screening, diagnosis, and treatment across all provinces in Pakistan. This innovative collaboration of private health care providers, private labs, and TB patients facilitates digital technology access, as well as various tools that foster quality of care and provide free resources for presumptive TB patients.

This market-driven approach of NTP/ PTP was revolutionary because it demonstrated that it is possible to engage the private sector in TB management while rapidly scaling up high-quality care for patients.

• REINFORCING GENOME SEQUENCING AND RECONNAISSANCE
  
  

GENE XPERT 

Genome sequencing and surveillance are also critical innovations for improving healthcare system preparedness and resilience to tuberculosis. 

Genome sequencing (the process of interpreting the genetic material found in a virus) and genomic surveillance (the use of sequence data to identify new variants and track existing ones) inform real-time testing, diagnostics development, and treatment protocols, allowing policymakers and health care providers to adapt their TB response in real-time.

Both technologies are well known for detecting and tracking new coronavirus variants, but they are less well known for their important role in tracking and managing tuberculosis and other diseases.

As a result, the Provincial Tuberculosis Control Program established Programmatic Management of Drug-Resistant Tuberculosis Unit (PMDT) Sites in various districts of Punjab to strengthen genome sequencing and surveillance, specifically for use in assessing antimicrobial resistance in TB, which can lead to drug-resistant (DR), multidrug-resistant (MDR), or extremely drug-resistant (XDR) TB.

Such evaluations ensure that tuberculosis patients are on the most effective and efficient treatment regimen for their particular case. This not only improves the chances of recovery for TB patients, but it also strengthens public health systems' ability to "get ahead" of TB and other diseases in real-time." Said Dr. Usman Lodhi, Provincial coordinator for DR-TB.

Dr. Muhamamd Asif, Program Manager provincial TB Control Program said that “Innovative technologies such as rapid diagnostic testing Services allow public health providers to identify patients with tuberculosis and identify resistance patterns of Antituberculosis Drugs in a short period, which is critical for initiating treatment early and reducing infection transmission to healthy people.

• CASE DETECTION AND DIAGNOSIS AIDED BY ARTIFICIAL INTELLIGENCE

CAD-4 TB - ARTIFICAIL INTELLIGENCE 

While excellent private-sector medical services and genome sequencing are key developments for managing the entire TB care cascade, patients must first have access to accurate and timely TB diagnoses. One method for increasing access is to use computer-aided detection software and artificial intelligence (AI).

"X-ray is an important tool for screening for tuberculosis and aiding in diagnosis,"  "However, X-rays are expensive, time-consuming to interpret, and subject to inconsistency and variability among radiologists.

To address these challenges, the Provincial TB Control Program collaborated with partners in Punjab to facilitate the use of cutting-edge computer-aided detection software and artificial intelligence (AI), which can accurately and quickly identify probable TB and confirm what type of TB a patient has (sensitive TB or DR-TB) while reducing the patient's cost and time burden.

ACCEPTING CHANGE TO IMPROVE TUBERCULOSIS CARE

Embracing Change in Healthcare

Adapting and strengthening innovative new tools and systems that fit within local systems and contexts has been critical to the Provincial TB Control Program and our partners' ability to reduce the prevalence and incidence of tuberculosis. We will be better equipped to strengthen high-quality primary health care and reimagine integrated person-centered care if we continue to prioritize constant innovation in our work.

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