Experts, NGOs oppose WHO proposal on TB

January 31, 2011

Published: Sunday, Jan 30, 2011, 14:06 IST

By Nozia Sayyed | Place: Pune | Agency: DNA

The World Health Organisation's (WHO) South-East Asia regional office (Searo)

proposal ofswitching on to daily directly observed treatment (DOT ) from

intermittent DOT (taken thrice weekly in India) was rejected by the programme

officers and TB officials on the second day of the meet on Galvanising evidence

for HIV management at the National AIDS Research Institute (NARI) on Friday.

The opinion was voiced by all the programme officials and NGOs present, arguing

that the evidence produced by the WHO officials was weak and the switch from

intermittent to daily may not prove

feasible.

The officials present including Dr D Behera (Delhi), Dr RR Katti (head for TB

and HIV co-infection Maharashtra) and Dr R Sareen (Delhi) refuted the

recommendation by Searo and suggested stronger evidence that can support the

advice put forward by the WHO tuberculosis official.

Katti, along with other TB officials said, " We cannot change the TB treatment

regimen to daily till we have a strong research results supporting it, " he said.

A total of 1.5 million patients suffer from tuberculosis in India. " Annually the

success rate of covering these patients is around 87%, which is higher than any

other country. This was possible through RNTCP (Revised National Tuberculosis

Control Programme) under which we are giving intermittent DOT that has more

advantages than the daily DOT. It has better efficacy and less toxicity than the

daily DOT, " said Dr VM Ajay Kumar, WHO's national consultant for RNTCP.

Explaining the advantages he said, " Intermittent DOT is taken thrice a week that

makes sure self supervision and reduces daily visit to the DOT centre and the TB

officer, who have to observe and watch the patient till he gulps down the pill.

Also, the dose is smaller. "

The proposal was presented by Dr Puneet Dewan, medical officer for tuberculosis

wqith Searo, who presented a meta-analysis that was put together after

collecting various global studies. He told DNA, " We have only recommended. We

cannot force the country to change its TB treatment regimen. "

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