Much shorter TB treatment offers hope
The breakthrough was revealed last week by José Luis Castro, Executive Director for the International Union Against Tuberculosis and Lung Disease (The Union).
On Wednesday evening he, along with a team of TB experts, announced the final results of the Francophone study which evaluated the efficacy of a shorter MDR-TB treatment regimen in nine African countries.
Higher chance of being cured
Three quarters of people in the study were cured with the new nine-month regimen. Of the patients who successfully completed the treatment – the cure rate was almost 90 percent.
Only half of patients taking the older regimen can expect to be cured even after taking drugs for over 20 months. Just completing this course, whether it cures one or not, is a feat of sheer determination, according to TB advocates speaking at the 47th Union World Conference on Lung Health taking place in Liverpool, United Kingdom, this week.
The study was conducted among 1006 people with MDR-TB in Benin, Burkina Faso, Burundi, Cameroon, Central African Republic, Côte d’Ivoire, Democratic Republic of the Congo, Niger and Rwanda.
Updated guidelines for MDR
Based on the preliminary results of this study, in May this year the World Health Organisation (WHO) officially recommended this regimen for MDR-TB patients who have not taken treatment before and who are not resistant to the drugs contained in this regimen.
These final results are expected to give countries the data needed to start rolling out the regimen to all eligible patients.
“With strong evidence now showing that this regimen is the most effective available for treating multi-drug-resistant forms of TB, the next step is for countries to begin widely implementing this new approach,” said The Union’s Dr Arnaud Trebucq.
South Africa will begin implementing the nine-month regimen from early next year and is currently developing an implementation plan, according to National Department of Health deputy director general, Dr Yogan Pillay.
South Africa set to benefit
“A shorter regimen means shorter duration for patients, decreased pill burden and a more rapid return to health. It also means less pressure on the health system and will reduce the costs of treatment,” he said.
Patients taking the nine-month regimen have a higher chance of being cured and are less likely to suffer from the potentially debilitating side-effects of these drugs, like deafness, blindness and nerve damage.
This is largely because the daily injectable drugs, which cause much of the long-term side-effects, have been shortened to four months. In the existing regimen patients receive six months of daily painful injections. Decreasing the duration of these drugs specifically is hoped to reduce the risk of long-term suffering, but it does not eradicate it.
Side-effects are still a concern: 45 percent of patients still suffered some form of hearing loss. Three percent were left completely deaf.
Local survivor urges action
South African TB survivor Phumeza Tisile, who became deaf as a result of MDR-TB treatment she started taking in 2010, urged the world to “respond to the emergency that is drug-resistant TB (DR-TB)”.
Last month the WHO published new data showing that rates of DR-TB around the world were higher than previously thought and constitute a “crisis”: in 2015 almost 600 000 people became ill with DR-TB. Less than one in five of these people were actually diagnosed and received treatment – treatment which only cures a fraction of people who take it.
Castro said this “gap allows DR-TB to spread” which is why giving people access to new drugs and treatment regimens is essential “in the fight against TB”.
After months of ineffectual treatment Tisile was diagnosed with an even more dangerous strain of the disease: extensively drug-resistant TB (XDR-TB) for which survival rates are as low as 20%. Through the international organisation Doctors Without Borders (MSF) she received an expensive drug, not available to most South Africans, and was finally cured in 2013. She said even though she lost her hearing, she was lucky as she still has her life.
Resistant TB: an emergency
“I’ve lost many people, friends, who were not lucky enough – who weren’t as lucky as I was.”
Through crowd-funding and support from a range of sources, Tisile received cochlear implant surgery in 2015 and “can hear again”. She said this cost half a million rand – an expense most people in the same situation cannot afford.
“Most people are not as lucky as me. I have had a happy ending but it scares me that many others don’t. In the recent UNIADS 90 90 90 strategy for HIV, TB was mentioned only three times, as though it is not important, as though it is not an emergency,” she said.
Tisile has dedicated her life to TB activism: she urged the international community to stop turning a blind eye to the hardships suffered by people living with TB.
“We are not TB cases, we are people living with TB. We are not things, we are living human beings.” – Health-e News.
An edited version of this story was published in the Daily News
Author
Republish this article
This work is licensed under a Creative Commons Attribution-NoDerivatives 4.0 International License.
Unless otherwise noted, you can republish our articles for free under a Creative Commons license. Here’s what you need to know:
-
You have to credit Health-e News. In the byline, we prefer “Author Name, Publication.” At the top of the text of your story, include a line that reads: “This story was originally published by Health-e News.” You must link the word “Health-e News” to the original URL of the story.
-
You must include all of the links from our story, including our newsletter sign up link.
-
If you use canonical metadata, please use the Health-e News URL. For more information about canonical metadata, click here.
-
You can’t edit our material, except to reflect relative changes in time, location and editorial style. (For example, “yesterday” can be changed to “last week”)
-
You have no rights to sell, license, syndicate, or otherwise represent yourself as the authorized owner of our material to any third parties. This means that you cannot actively publish or submit our work for syndication to third party platforms or apps like Apple News or Google News. Health-e News understands that publishers cannot fully control when certain third parties automatically summarise or crawl content from publishers’ own sites.
-
You can’t republish our material wholesale, or automatically; you need to select stories to be republished individually.
-
If you share republished stories on social media, we’d appreciate being tagged in your posts. You can find us on Twitter @HealthENews, Instagram @healthenews, and Facebook Health-e News Service.
You can grab HTML code for our stories easily. Click on the Creative Commons logo on our stories. You’ll find it with the other share buttons.
If you have any other questions, contact info@health-e.org.za.
Much shorter TB treatment offers hope
by Amy Green, Health-e News
November 3, 2016
Related
‘Why do we have a COVID-19 vaccine before a TB vaccine?’ and other tough questions on #WorldTBDay
This World TB Day, international expert José Luis Castro answers the six tough questions about TB. Health-e News editor Amy Green asked what the real impact of COVID-19 on tuberculosis (TB) has been, why TB doesn’t have a vaccine for half a century, and why TB funding pales in comparison to funding for COVID-19.
US approves new TB drug tested in South Africa
The world is one step closer to ending the deadliest form of the deadliest infectious disease known to man: extensively drug-resistant tuberculosis (XDR-TB).
‘Soda taxes work’
Sugary drink consumption has been slashed by more than half, three years after the city of Berkeley introduced a levy on these products.