With the rise in Multi-Drug-Resistant Tuberculosis or MDR-TB cases, the health ministry has been implementing the latest interventions. A shorter regimen with fewer side effects for MDR-TB started in June last year. So far, 18 people have been treated under the new regimen at the Gidakom Hospital in Thimphu. A regimen is a prescribed course of medical treatment.
According to health officials from the Gidakom Hospital, the new regimen has so far shown no major side effects apart from nausea.
Under the new regimen, patients need not stay for longer duration in hospital unlike the previous one.
The regimen includes two types of medication.
According to the health ministry, this is the latest intervention based on World Health Organisation’s recommendations and guidelines.
Dr Chimi Dema, GDMO, Gidakom Hospital said “So, in the BPaLM regimen, we have four drugs which are given for six months. In the nine-month oral regimen, we have seven drugs, which are given for nine months. So, in the past, the shorter regimen was given for around nine to 12 months and the longer regimen was given for 18 to 20 months. The shorter regimen had around seven drugs and the longer regimen had only four drugs, but then it was given for around two years, 18 to 20 months.”
Thinley Gyeltshen, Staff Nurse of Gikakom Hospital said “Right now, the medicine is less and they do not have much effect on their appetite. If they want to throw up, medicine can cure them. Unlike in the past, they do not have to stay for long so we also feel the work is easier. Earlier, patients had to wait till their culture result came out and they had to stay at the hospital for a long time.”
They added that under the previous regimen, a few patients used to suffer from mental health as they were hospitalised for extended period of time.
According to the health ministry, Bhutan has an incidence rate of 22 per 100,000 people of MDR-TB.
The ministry records show MDR cases have been on the rise. There were 63 cases in 2023 from 61 and 55 cases in 2022 and 2021, respectively.
However, the ministry has been trying to improve access to detecting the disease using the latest WHO-recommended machines such as GeneXpert, microscopy and X-rays.
Deki Yangzom, Chief Programme Officer, Communicable Disease Division said “Now the GeneXpert test is the first line diagnostic test in addition to x-ray and microscopy. So, we have also been able to procure a TB mobile truck through support from Global Fund, which has a digital x-ray and GeneXpert machine. So, once this mobile truck is operational, we expect that it will be able to cover all the high-risk populations such as schools, institutes, industries and construction sites.”
She also said the ministry actively does contact tracing of those who came in contact with TB patients.
According to the WHO, MDR-TB continues to emerge and spread because of mismanagement of TB treatment and person-to-person transmission.
Singye Dema
Edited by Tshering Zam
