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Hyderabad: Latent TB poses bigger risk

A person with LTBI has small quantities of dormant tuberculosis bacteria. The patient exhibits no symptoms of the disease.

Hyderabad: Active tuberculosis (TB) infections could only be the tip of the iceberg. It is the latent tuberculosis infection (LTBI) that makes up the largest portion of this proverbial iceberg, not so well known but is as dangerous as TB infections.

Experts who came to attend a session of ‘The Union World Conference on Lung Health’ on Friday said there could be disastrous consequences if measures are not taken to address the issue of LTBI. The session was held at a convention centre in Hyderabad, as part of a four-day conference being organised by the Interna-tional Union Against Tuberculosis and Lung Health, known as ‘the union.’A person with LTBI has small quantities of dormant TB bacteria. He/she does not show any symptoms or signs of the disease and is not infectious. An alarmingly high number of people — 40 per cent of Indians according to some studies — have LTBI. If left untreated, 5-10 per cent of them can develop TB over their lifetimes. Conditions such as diabetes, malnourishment and HIV increase the chances of persons with LTBI developing TB in their lifetimes. It is estimated that a quarter of the world’s population, 1.7 billion people, has LTBI.

The Centre had earlier announced its intentions to eliminate TB from the country by 2025, Dr Sundari Mase, a TB consultant for the WHO, said, adding that it wouldn’t be possible if LTBI is ignored.

“India has the highest burden of LTBI and TB in the world. Tackling it will be key,” she said.

Dr Rohit Sarin, director of the National Institute for Tuberculosis and Respiratory Diseases, New Delhi, made it clear that it isn’t necessary for everyone to undergo preventive treatment.

“There are some very high-risk groups who we suggest undergo TB Preventive Therapy (TBPT) without any testing. These include people who are tested HIV positive and people in direct contact with patients with active TB infections. The-re are groups who are also at risk, such as prisoners, health workers and immigrants from countries with high TB burden, who we also suggest undergo tests for LTBI before any preventive treatment,” he said. Dr Srinath Satyanarayana, deputy director, Centre for Operations Research of the Intern-ational Union against Lung Disease and Tub-erculosis, argued for better links between stakeholders working on TB prevention and treatment across the world.

“For the world to meet targets under the UN’s sustainable development goals-3 (on health), such as reducing the number of preventable deaths and end epidemics of communicable diseases, tackling LTBI is crucial,” he said.

Mr Mallesh, a TB survivor from Hyderabad, spoke on his trials and tribulations: “After I was diagnosed with TB, my wife and I decided that she and our three children should live away from each other so that they don’t get TB. We were separated for a year. One of our daughters caught TB. If TB can be prevented, it should be,” he said.

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