THE HINDU Editorial Vocabulary-May 12, 2017- Topic 2

TB timelines

Nearly two months after the Health Ministry set the ambitious target of working towards elimination of tuberculosis by 2025, a study published in The Lancet indicates that India’s TB crisis is set to snowball by 2040 when one in 10 cases could be drug-resistant — both multidrug-resistant TB (or MDR-TB, resistant to more than one of the first-line drugs) and extensively drug-resistant TB (or XDR-TB, also resistant to fluoroquinolones and at least one of the second-line injectable drugs). 

What is even more alarming is the projection that the increased number of drug-resistant cases will come from direct transmission from infected people to others rather than by strains acquiring resistance to TB drugs during treatment due to inadequate treatment or discontinuation of treatment midway. The study found that “most incident” MDR cases are “not caused” by acquired drug resistance, which will become a “decreasing cause” of drug-resistant TB. The increased availability of drugs to fight drug-sensitive TB has led to the emergence of MDR-TB strains. With an increasing number of MDR-TB cases, there has been a shift in the way people get infected with drug-resistant TB — from strains acquiring drug resistance during treatment to direct transmission of MDR-TB strains from an infected person. The same trend is seen in the case of XDR-TB too. As a result, in high MDR-TB burden countries such as India, improved treatment outcomes in people might only reduce and not eliminate drug-resistant TB. Till 2015, only about 93,000 people with MDR-TB had been diagnosed and put on treatment.

The study, based on a mathematical model to forecast how TB is likely to progress in the four most-affected countries (Russia, the Philippines, South Africa, India), suggests that new MDR-TB cases a year in India will touch 12.4% by 2040, up from 7.9% in 2000. With respect to XDR-TB, the incident cases will rise to 8.9%, from 0.9% in 2000. In 2015, the four countries accounted for about 40% (more than 230,000) of all drug-resistant TB cases in the world. Besides targeting early diagnosis and treatment of those with the disease, India’s TB control programme has identified enhanced interventions to break the transmission cycle of the bacteria in the community. Contact screening of family members and preventive treatment of all children below the age of five who have not developed the disease are already a part of the Revised National Tuberculosis Control Programme, but rarely done. Another important strategy that has to be adopted is making drug-susceptibility testing universal and mandatory. Developing more accurate, cheaper and effective diagnostic tests and improved treatment regimens that are less expensive and of shorter duration will also go a long way in winning the war against the disease.

Vocabulary

Ambitious: having or showing a strong desire and determination to succeed.

Example: His mother was hard-working and ambitious for her four children

Synonyms: aspiring, determined, forceful, pushy, enterprising, motivated

Resistant: offering resistance to something or someone.

Example: Some of the old churches are resistant to change

Synonyms: impervious to, unsusceptible to, immune, invulnerable to

Forecast: predict or estimate a future event or trend.

Example: Rain is forecast for eastern Ohio

Synonyms: predict, prophesy, prognosticate, foretell, foresee

Susceptibility: the state or fact of being likely or liable to be influenced or harmed by a particular thing.

Example: Lack of exercise increases susceptibility to disease

Regimen: a prescribed course of medical treatment, way of life, or diet for the promotion or restoration of health.

Example: A regimen of one or two injections per day

Strain: a force tending to pull or stretch something to an extreme or damaging degree.

Example: The usual type of chair puts an enormous strain on the spine

Synonyms: tension, tightness, tautness

Diagnosed: identify the nature of an illness or other problem by examination of the symptoms.

Example: Doctors diagnosed a rare and fatal liver disease

Synonyms: identify, determine, distinguish, recognize, detect, pinpoint

Preventive: designed to keep something undesirable such as illness, harm, or accidents from occurring.

Example: Preventive medicine

Synonyms: preemptive, deterrent, precautionary, protective; prophylactic

Enhanced: intensify, increase, or further improve the quality, value, or extent of.

Example: His refusal does nothing to enhance his reputation

Synonyms: increase, add to, intensify, heighten, magnify, amplify