Determine the Mycobacterium tuberculosis resistance and sensitivity pattern in the Dhaka South City Corporation (DSCC) area using 10-color GeneXpert assay with XDR cartridge

 Bangladesh is one of the high-burden countries of drug-resistant tuberculosis (TB) in the world. Only early diagnosis and proper selection of anti-tubercular treatment (ATT) combat the crisis. The study aims to determine M. tuberculosis resistance and sensitivity pattern in the Dhaka South City Corporation (DSCC) Area.

A cross-sectional observational study designed to determine the M. tuberculosis résistance and sensitivity pattern with Xpert XDR cartridge assay at RTRL, Shamoli. The potential drug resistance TB patients go for Xpert XDR assay, a molecular diagnostic test to determine the M. tuberculosis resistance and sensitivity pattern.

 

One hundred nine potential drug resistance TB patients Xpert XDR assay was done. The result shows that working-class male of productive age suffers more. DR-TB presumptive age group among people of 35-44 years of age suffer more for DR-TB. It was 24 (22%), and followed by people 25-43 years of age. They were 20 (18.3%). The elderly people also suffered more and were above 65 years of age. They were 14 (12.8%).

Age Group
		Frequency	Percent	Valid Percent	Cumulative Percent
Valid	5-14	2	1.8	1.9	1.9
	15-24	21	19.3	20.0	21.9
	25-34	20	18.3	19.0	41.0
	35-44	24	22.0	22.9	63.8
	45-54	13	11.9	12.4	76.2
	55-64	11	10.1	10.5	86.7
	>65	14	12.8	13.3	100.0
	Total	105	96.3	100.0
Missing	System	4	3.7
Total		109	100.0

 

DR-TB presumptive resistance and sensitivity pattern. Among 109 XDR assays, INH resistance was 25 (22.9%), Fluoroquinolone resistance was 3 (2.6%), and All MDR-TB were sensitive in 64 (58.7%). M. tuberculosis was not detected among 10 (9.2%).

Resistance and Sensitivity
		Frequency	Percent	Valid Percent	Cumulative Percent
Valid	INH	25	22.9	23.6	23.6
	RIF	4	3.7	3.8	27.4
	FLQ	3	2.8	2.8	30.2
	Sanative	64	58.7	60.4	90.6
	No Mtb	10	9.2	9.4	100.0
	Total	106	97.2	100.0
Missing	System	3	2.8
Total		109	100.0

Early diagnosis and proper selection of anti-tubercular treatment (ATT) for drug resistance TB (DR-TB) is mandatory. It can be achieved with rapid molecular drug sensitivity testing and administering all oral shorter treatment regimens (SOTR) for drug-resistant TB patients.

Hasina Akhter¹, Syed Sakhawat Hussain² , Ahmed Parvez Zabeen³

¹Associate Professor, Department of Microbiology, Bangladesh Dental College, Dhaka, ²Professor Department of Biochemistry, Parkview Medical College, Sylhet, ³Dr. Ahmed Parvez Zabeen, Divisional Tuberculosis (TB) Expert, National Tuberculosis Control Program (NTP), Bangladesh

Parkview Medical Journal 

An official Journal of Parkview Medical College, Sylhet, Bnagladesh 

TB Global Leaders Visit Bangladesh

The Global Fund to Fight AIDS, Tuberculosis and Malaria (GFATM) and STOP Partnership's senior team visited Bangladesh. Both Executive Directors visited together to support Bangladesh's goal to END TB by 2030. Bangladesh is the seventh high-burden country in the world for TB. Both drug-sensitive TB and drug-resistant TB are prevalent in Bangladesh.

Mr. Peter Sands and Ms. Lucica Ditiu with Honorable Prime Minister Sheikh Hasina at Gonobhaban

Mr. Peter Sands, ED, GFATM, and Dr. Ahmed Parvez Zabeen, Divisional TB Expert, Dhaka, NTP

Ms. Lucica Ditiu, ED, STOP TB Partnership, and Dr. Ahmed Parvez Zabeen, Divisional TB Expert, NTP, Bangladesh

GFATM Team 

The GFATM Team at Community Clinic (CC), Rupgang, Narayanganj

The GFATM Team at Mugda Medical College and Hospital, Dhaka 

Ms. Luciaca, ED, STOP TB Partnership, Dr. Ahmed Parvez Zabeen and Dr. Ayesha Akhter, Deputy Director, Shamoli TB Hospital, Dhaka    

During their visit, the Executive Directors of GFATM and STOP Partnership, Mr. Peter Sands and Ms. Lucica Ditiu, paid a courtesy call to Honorable Prime Minister Sheikh Hasina. They were impressed by the Prime Minister's comprehensive knowledge of Tuberculosis, AIDS, and Malaria. The Global Fund and Stop TB Partnership aim to involve Prime Minister Sheikh Hasina in their coalition of leaders as a champion of The Global Fund (GFATM). The list of coalition leaders includes Indian Prime Minister Narendra Modi and Brazilian President Luiz Inácio Lula da Silva, among others. These two organizations mainly focus on TB, HIV, and Malaria in Bangladesh and seek to strengthen their relationship with the country. The Executive Directors also expressed their desire for Prime Minister Sheikh Hasina to leverage her connections and networks with world leaders for funding to eliminate Tuberculosis, AIDS, and Malaria.

Subsequently, the GFATM and STOP TB Partnership Executive Directors and their team visited Tuberculosis Control activities at the community and facility levels.

TB District Surveillance Medical Officers are an integral part of NTP, Bangladesh

 

TB District Surveillance Medical Officers are an integral part of NTP until Bangladesh reaches the End  TB by 2030 - Dr. Zabeen

TB District Surveillance Medical Officers (DSMOs) is a part of the National Control Programme (NTP), in Bangladesh to END TB by 2030. Dr. Ahmed Parvez Zabeen, Divisional TB Expert, Dhaka South stresses the need for the DSMOs continuity in NTP until Bangladesh reaches Zero TB Deaths, Zero Tuberculosis, and Zero catastrophic cost. Dr. Zabeen further added that DSMOs hired by The Global Fund to Fight AIDS, Tuberculosis and Malaria  (GFATM) grant and requests government officials to include them in the currently developing operational plan of the Ministry of Health and Family Welfare (MoH&FP) to reach the Sustainable Development Goal (SDG) targets on TB at the DSMOs get together meeting. 

                              Dr. Ahmed Parvez Zabeen

Dr. Ibrahim Mazi, DSMO, Shariatpur informed the meeting about the DSMOs' different field-level activities. Dr. Joieta Tushi, DSMO, Naogoan, and others anchored the meeting. The DSMOs Welcomed the guests with flowers. The meeting ends with a video presentation of different field-level activities of all DSMOs.

Dr. Md Mahfuzur Rahman Sharkar, Line Director TB–Leprosy, and ASP presided over the meeting.

 

World TB DAY 2024

World TB DAY 2024

Civil Society Note

Point to Ponder

Dhaka begins the World TB Day 2024 celebration with the call YES! WE CAN END TB. The last year’s theme’s continuation YES! WE CAN END TB by 2023 to bring powers collectively to achieve the United Nations High-Level Meeting (UNHLM) on Tuberculosis 2023’s political targets to END TB; the theme narrates a few more things like the engagement of those affected by TB, communities, and civil society to lead the movement to END TB. 

The TB STUDY GROUP (TSG), a civil society organization in Bangladesh believes that diagnosis of Tuberculosis is difficult. The TSG stresses the expansion of molecular WHO Recommended Diagnostics Cartridge-based Nucleic Acid Amplification Test (CB-NAAT)- GeneXpert and Tuenut, innovation of newer drug for short-course treatment and use of Artificial Intelligence (AI) for ending this disease. 

 

The TSG also recommends early availability of anti-TB vaccine; the few anti-TB vaccine candidates in phase III trial. Those vaccines must complete the trials soon, the completion of safety tests, and those anti- TB vaccines must be available to save more lives from tuberculosis. 

 

The TSG firmly believes in the strength of those affected by Tuberculosis, communities, and civil societies that YES! WE CAN END TB; হ্যাঁ! আমরা যক্ষ্মা নির্মূল করতে পারি ।

Preventing Resistant Mycobacterium Tuberculosis Together

 World AMR Awareness Week (WAAW), 2023

Civil Society Note 

Point to Ponder 

World AMR Awareness Week (WAAW) begins on 18 November; it will end on 24 November 2023 with a call Preventing Antimicrobial Resistance together to generate awareness among people about the menace of the development of resistance against all antimicrobial agents. Currently, resistance is growing against the ancient bacteria Mycobacterium Tuberculosis. The anti-tubercular drugs Rifampicin, Isoniazid, Pyrazinamide, and Ethambutol are administered to treat all forms of Tuberculosis. All these drugs have nowadays developed resistance, making TB Treatment difficult. One school of thought believes that development-resistant Mycobacterium Tuberculosis is a sequel of man-made phenomenon. The appropriate dose and schedule can prevent resistance if Directly Observed Treatment (DOT) is maintained.

TB Study Group (TSG) on World AMR Awareness Week calls for the proper administration of DOT for all forms of TB Treatment to prevent Resistant Mycobacterium Tuberculosis together.   

Urgently ENDING TB Needs Uninterrupted Supply Chain

Civil Society Note 

Point to Ponder 

Urgently Ending TB is a mammoth task for TB Advocates, activists, and healthcare workers. Other points that hampered the effective TB Control Program are wide gaps between TB commitments and TB realities like on-the-ground budgetary allocation and availability of funds with the Ministry of Health (MoH), and the National Tuberculosis Control Program to procure the anti-TB drug and reagent in time. Therefore, uninterrupted drug supplies and reagents face shortages at the community level.

Hence, implementation of quality Directly Observed Treatment Short Course (DOTS) to save lives. It is the duty of the government to allocate resources timely and adequately to ensure effective TB services to save lives.

United Nation High Level Meeting (UNHLM) 2023

Civil Society Note

Point to Ponder 

UNHLM 2023 on TB

(22 September 2023)

TB STUDY GROUP (TSG) humbly requests all UN member states to allocate adequate resources for urgently Ending TB worldwide. TSG also urges to set up a realistic target for diagnosing and treating all forms of TB; unrealistic targets can be misleading for TB workers to End TB.

Dr. Ahmed Parvez Zabeen, Honorary Chief Executive Officer (CEO), TB STUDY GROUP

An effective TB vaccine is needed to prevent TB from Latent TB Infection (LTBI) by 50%. The heads of government and states who will attend the 78th UNGA firmly plead to allocate enough funds for effective TB vaccine development as soon as possible to make a TB-free World.