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Tuberculosis of brain, spine on rise -Chetana Belagere

-The New Indian Express

Whole Genome Sequencing can detect cases; extra-pulmonary forms increasing in kids

BENGALURU: Multi Drug Resistant (MDR) TB continues to be on the rise. In many cases, this is leading to tuberculosis of the brain and spine. Experts working in the control room of TB burden in the state, say this area is overlooked and undiagnosed. 

“Extra-pulmonary manifestations of Tuberculosis are on the rise, with Tuberculosis of brain and spine cases increasing. TB mainly affects the lungs, which is called pulmonary tuberculosis, but if it affects other organs such as brain, spine, uterus, heart, skin etc, it is known as extra-pulmonary TB. These cases are on the rise,” said Dr Sachet Dawar, Assistant Professor, Dept. of Respiratory Medicine, Noida International Institute of Medical Sciences.

In case of TB of the brain, the bacilli enters the blood vessels when someone with TB sneezes or coughs, and then go into the brain, causing inflammation of the Central Nervous System, causing meningitis. With TB meningitis, the person can have symptoms of repeated fever and headaches and also in later stages, go into confusions and coma. Similarly, the TB bacilli enters the spinal area of the body, leading to TB of the spine -- Pott’s Disease symptoms of severe backache and degeneration of bones.

However, doctors claim the world is effectively treating drug-susceptible forms of TB, and if it doesn’t, community transmission of drug-resistant forms of TB can snowball into a difficult-to-treat endemic.
Stressing on diagnosis, pulmonary experts say the available tests are not enough.

They are now calling for a wider rollout of ultra-sensitive tests to get conclusive results, as well as the use of newer specimens such as stool samples, which could also be easier to detect paediatric cases. They also cite the need for whole genome sequencing (WGS) on a large scale, to detect MDR TB cases. “Though a battery of common Multi Drug Resistant TB tests is available, these tests fail to detect it,” said a senior health department official. WGS, doctors claim, can emerge as the revolutionary one-stop solution for diagnosis and treatment of TB in India. 

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