4.3 Review

Evolutionary journey of programmatic services and treatment outcomes among drug resistant tuberculosis (DR-TB) patients under National TB Elimination Programme in India (2005-2020)

Journal

EXPERT REVIEW OF RESPIRATORY MEDICINE
Volume 15, Issue 7, Pages 885-898

Publisher

TAYLOR & FRANCIS LTD
DOI: 10.1080/17476348.2021.1850277

Keywords

MDR-TB; Universal Drug Susceptibility Testing (UDST); treatment outcomes; programmatic management of drug-resistant TB

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This document presents the evolution and progress in treatment outcomes among multidrug-resistant TB (DRTB) patients in India since 2005, as well as the challenges and opportunities in nationwide scale-up of evidence-based policies and services. Interventions introduced in recent years are enhancing survival and success rate in DR-TB patient cohorts.
Introduction: India, with one-fourth of global burden of tuberculosis as well as multidrug-resistant TB, made bold commitment to end TB by 2025. There is no documented comprehensive review of the evolutionary journey of India's DRTB service expansion and changes in the treatment outcome so far. Area Covered: The current document presents evolution and journey of programmatic services and the progress in treatment outcomes among DRTB patients since 2005 with efforts cum challenges in nationwide scale-up of evidence-based policies and services, opportunities and future prospects for universalizing quality care - an essential ingredient to end TB in India. In the era of standardized longer treatment regimen till 2017, only half of the patients were successfully treated. Interventions to address factors associated with access and quality of care introduced since 2018 like universal drug susceptibility testing (UDST) guided treatment with shorter regimen, newer drugs, social protection; accelerated detection and began enhancing survival and success rate in recent DR-TB patient cohorts. Expert Opinion: Patient-centric care; robust TB/DR-TB surveillance system, shorter effective safer regimens and innovations, a milestone essential to end TB in India by 2025 to accomplish the vision of the Prime Minister of India.

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