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India Revises National TB Prevention Guidelines Using Findings from Indo-JHU Research
Accounting for the largest absolute burden of tuberculosis (TB) globally, India’s national mitigation efforts are critical for preventing disease transmission. Recently, India’s National TB Elimination Programme revised its guidelines for preventing infection among household contacts of confirmed pulmonary TB cases, recommending Tuberculosis Preventive Therapy (TPT) for people who are exposed in the home. Among the data used to support the change in guidelines are findings from a study conducted collaboratively by researchers at Byramjee Jeejeebhoy Government Medical College (BJGMC) in Pune, the National Institute for Research in Tuberculosis (NIRT) in Chennai, and Johns Hopkins University.
Led by Dr. Mandar Paradkar, the study team enrolled adult and pediatric household contacts of pulmonary tuberculosis patients in Pune and Chennai during a 3-year period. “Of 997 participants who completed the study, 71% tested positive for TB infection at the beginning of the study and 2% developed TB disease over the 24-month follow-up period, pointing to an alarming transmission rate” says Dr. Paradkar. Last year Johns Hopkins Medicine announced publication of the findings.
“If we can screen patients early and get their household contacts on preventive therapy, we have an opportunity to stop the chain of this horrible disease,” says Dr. Sanjay Gaikwad, Head of the TB Department of BJGMC. “The studies we conduct support actions that can save lives.”
“The goal of all research we do is to inform better healthcare practices that improve outcomes for patients” notes Dr. Amita Gupta, Johns Hopkin University’s senior investigator on the study. “It’s gratifying when health policy makers make evidence-based changes to care guidelines that are rooted in the hard work of the team in India.”
While the WHO had changed its prevention guidelines for high burden countries to include Tuberculosis Preventive Therapy for most household contacts, India required TPT only for children under age 6 and people living with HIV. “The new revisions recognize the growing data in support of TPT for household contacts of confirmed TB cases,” says Dr. Padmapriyadarsini Chandrasekaran, who led the study at NIRT.