TB 101 Series 2023: Session 4 - Treatment of LTBI

[@judson4902]

Promo-SM

[@vib_di]

The existence of disparities in medical treatment between developed and underdeveloped nations raises questions about the effectiveness of certain resources, such as educational videos. As an individual from India, my recent experience with a positive QuantiFERON TB IGRA test has led to serious concerns about the prescribed treatment plan. (I recently relocated to Bangalore from my hometown, where I developed symptoms such as a runny nose, frequent tremors while sleeping, and a mild cough. Over the course of three months, my symptoms worsened, and I experienced weight loss and night pains in my legs, prompting my family to advise me to take a TB test, which turned out to be positive.) Upon receiving the diagnosis, I was prescribed steroids due to my allergies, with instructions to use them whenever symptoms arise, potentially for a lifetime. This alarmed me due to the negative reputation steroids have in terms of their impact on health. Consequently, I conducted research on the topic and discovered that I had Latent TB Infection (LTBI). Recommendations from the CDC and WHO emphasize the importance of ruling out active TB disease while advocating for preventive treatment of LTBI, especially for individuals at risk in high-incidence countries like India, even for those prescribed corticosteroids as immunosuppressants. However, to my dismay, I was refused preventive TB treatment, despite promising to adhere to the complete treatment regime. The reasoning behind this decision suggested that having TB bacteria in the body is acceptable as long as it remains non-harmful, drawing a flawed analogy to harboring a terrorist who has caused harm elsewhere but is currently inactive. This rationale appears illogical and unsettling, emphasizing the need for a more proactive approach to tackle latent TB infection. It's essential to remember that TB bacteria is a pathogen, not a probiotic. It's worth noting that international health organizations like the CDC and WHO recommend LTBI treatment, and India's Ministry of Health has issued guidelines supporting this approach. Despite these endorsements, the implementation of preventive measures seems to be lacking, possibly due to a growing divide between scientific knowledge and practical application. There appears to be a lack of logic and reasoning in the decision-making process. Every life should be valued equally, and everyone deserves the right to good health and proper medical treatment. Rather than refusing treatment, a focus on developing a robust healthcare infrastructure to enable accessible treatment options becomes paramount. Additionally, addressing LTBI in the developing world, where active TB can be diagnosed and treated promptly, plays a crucial role in achieving the World Health Organization's goal of ending TB by 2035. Treating latent TB infections can significantly reduce the overall burden of the disease and the risk of future complications. Individuals in underdeveloped nations should have the same opportunities for preventive treatment as those in developed countries. Ensuring that latent TB cases are managed effectively will be instrumental in achieving the WHO's ambitious target of eradicating TB by 2035.