Hindi English Translation || Editorial || ​Taking TB seriously: On the BPaLM treatment regimen for drug-resistant tuberculosis

​Taking TB seriously: On the BPaLM treatment regimen for drug-resistant tuberculosis

Early adoption of the new treatment regimen (उपचार योजना) is welcome

Time is of the essence (to be the most important thing) in adopting advanced technology in medical care. When medical technology arrives dragging its feet, then its transformative (परिवर्तनकारी) effects are not that dramatic. The Union Health Ministry’s decision to introduce the new treatment regimen for drug (दवाई)-resistant tuberculosis hardly (मुश्किल से) a couple of years after it was recommended by the World Health Organization (WHO) (Founded in 1948, WHO is the United Nations agency that connects nations, partners and people to promote health, keep the world safe and serve the vulnerable - so everyone, everywhere can attain the highest level of health), is a step in the right direction. Last (continue, go on, carry on, take) week, the government approved the BPaLM regimen comprising four drugs — Bedaquiline, Pretomanid, Linezolid and Moxifloxacin. This regimen has been proven to offer better outcomes (परिणाम), remarkably (उल्लेखनीय रूप से) shortening the duration of treatment, and resulting in (परिणामस्वरूप होना) improvements in quality of life for persons living with multidrug-resistant tuberculosis (MDR-TB), which resists treatment by isoniazid and rifampicin, the two hitherto (अब तक) frontline drugs (the most important medicine) in TB treatment. The move (कदम) makes tremendous (very great, huge, immense, massive, substantial) sense for a country that voluntarily (स्वेच्छा से) set itself an earlier target for TB elimination by 2025, five years ahead of the global target under the UN Sustainable Development Goals (संयुक्त राष्ट्र सतत विकास लक्ष्य). TB elimination means there should be under one case of TB for a population of 10 lakh. Traditional treatments can last up to 20 months, and entail (आवश्यक होना) severe side effects for the patient. The BPaLM regimen is reputed (माना जाना) to cure drug-resistant TB in just six months, with a high success rate. It is particularly significant in this country, because an estimated 75,000 people living with drug-resistant TB can now switch (बदलना) to this shorter, cheaper treatment regimen. This move, experts endorse (समर्थन करना), will undoubtedly (obviously, unquestionably, certainly, beyond doubt) improve treatment outcomes and help thousands of patients.

The government has, admirably (desirably, attractively, excellently), shown a commitment (responsibility, onus, accountability, obligation, liability) and political will (political desire/intention; administrative will) to see the back of (be rid of; to be freed from or to be relieved of (something unwanted)) TB, and has, over the years, implemented several measures (action, step, move, procedure) in aid of (in support of) this. Shifting from conventional (traditional, standard, typical, regular, common) culture and drug sensitivity testing (It determines which drugs can kill the tubercle bacilli. If the tubercle bacilli can be killed by a particular drug, they are susceptible to that drug. If tubercle bacilli can grow in the presence of a particular drug, they are resistant to that drug. (Tubercle bacillus is a bacterium of the genus Mycobacterium (M. tuberculosis) that causes tuberculosis in humans)) to rapid molecular tests (It facilitates early and accurate detection of people with TB, contributing to improved patient outcomes and reduced disease transmission) for diagnosing (identify the nature and cause of an illness/condition by examination) MDR-TB has resulted in improved case detection, higher treatment coverage, better treatment success rates, and falling death rates. Extra support (financially, nutritionally and societally) in the form of the Ni-kshay Mitra (This is an initiative under the “Pradhan Mantri TB Mukt Bharat Abhiyan (PMTBMBA), implemented by the Ministry of Health & Family Welfare that seeks to eliminate TB by 2025 - five years ahead of the global goal of 2030. First articulated by the Hon’ble Prime Minister in 2018, “Ni-kshay Mitra” is an initiative that provides for additional diagnostic, nutritional, and vocational support by elected representatives, corporates, organisations, NGOs, and individuals to those undergoing TB treatment. This in turn, would help them on their journey towards a successful recovery) scheme has also yielded (give, provide, produce) results. India’s reduction of TB incidence (It refers to the number of new cases that develop in a given period of time whereas “prevalence” refers to the number of cases of a disease that are present in a particular population at a given time) by 16% from 2015 to 2022 is almost double the pace at which global TB incidence is declining, as per WHO’s Global TB Report 2023. Mortality ((in a particular time/for a cause) the rate/number of death; death, loss of life) has also reduced by 18% during the same period in India. It was India which led the way earlier with its Directly Observed Therapy Short-course programme, revolutionising (transform, alter dramatically, shake up, restructure, reorganize, rejig, reform, recast, reshape) TB care back in the day (used to refer to an earlier time; used for talking about a time in the past) with supervised administration (the way by which a drug (medicine) is taken into the body) of drugs. Centring its patients, the government should not merely (only, simply, just) follow, but be a pioneer (trailblazer, innovator, groundbreaker, pathfinder, spearhead, trendsetter, avant-gardist) in diagnosing and treating TB.

Courtesy: The Hindu

Important Word List With Meaning

1.regimen (noun)

Hindi Meaning - उपचार योजना
English Meaning - A treatment plan that specifies the dosage, the schedule, and the duration of treatment.

2.drug (noun)

Hindi Meaning - दवाई
English Meaning - medicine, medication, medical drug.

3.transformative (adjective)

Hindi Meaning - परिवर्तनकारी
English Meaning - evolutionary, life-changing, developmental, revolutionary.

4.hardly (adverb)

Hindi Meaning - मुश्किल से
English Meaning - barely, almost not.

5.outcome (noun)

Hindi Meaning - परिणाम
English Meaning - consequence, effect, (end) result, implication.

6.remarkably (adverb)

Hindi Meaning - उल्लेखनीय रूप से
English Meaning - considerably, markedly, significantly, noticeably, distinctly, exceptionally.

7.result in (verb)

Hindi Meaning - परिणामस्वरूप होना
English Meaning - cause, lead to, bring on, bring about, give rise to.

8.voluntarily (adverb)

Hindi Meaning - स्वेच्छा से
English Meaning - willingly, freely, of one’s own free will, of one’s own volition.

9.UN Sustainable Development Goals (SDGs) (noun)

Hindi Meaning - संयुक्त राष्ट्र सतत विकास लक्ष्य
English Meaning -The 2030 Agenda for Sustainable Development, adopted by all United Nations Member States in 2015, provides a shared blueprint for peace and prosperity for people and the planet, now and into the future. At its heart are the 17 Sustainable Development Goals (SDGs) , which are an urgent call for action by all countries - developed and developing - in a global partnership.

10.entail (verb)

Hindi Meaning - आवश्यक होना
English Meaning - require, demand, call for, make necessary.

11.repute (verb)

Hindi Meaning - माना जाना
English Meaning - be regarded, be reported, be believed, be considered, be judged.

12.switch (verb)

Hindi Meaning - बदलना
English Meaning - change.

13.endorse (verb)

Hindi Meaning - समर्थन करना
English Meaning - support, back, approve (of), ratify, authorize, be in agreement with.

14.hitherto (adverb)

Hindi Meaning - अब तक
English Meaning - until now, up to this point, so far, thus far, to date.

15.move (noun)

Hindi Meaning - कदम
English Meaning - step, action, activity, measure.

16.BPaLM regimen (noun)

English Meaning - a novel treatment for Multi-Drug-Resistant Tuberculosis (MDR-TB) under its National TB Elimination Program (NTEP) as a highly effective and shorter treatment option. consists four-drug combination – Bedaquiline, Pretomanid, Linezolid and Moxifloxacin, has been proven to be safe, more effective and a quicker treatment option than the previous MDR-TB treatment procedure. While traditional MDR-TB treatments can last up to 20 months with severe side effects, BPaLM regimen can cure the drug-resistant TB in just six months with high treatment success rate. India’s 75,000 drug-resistant TB patients will now be able to avail benefit of this shorter regimen.

17.Multidrug-resistant TB (MDR TB) (noun)

English Meaning - Multidrug-resistant TB (MDR-TB) is TB that does not respond to at least isoniazid and rifampicin, the 2 most powerful anti-TB drugs.

18.Drug-Sensitive Tuberculosis (DS-TB) (noun)

English Meaning - DSTB is where a person is infected with TB bacteria that are susceptible to all first line anti-TB drugs. It means that all of the first line TB drugs will be effective as long as they are taken properly and regularly. This type of TB has the best prognosis (i.e. a prediction of the course of a disease) and the shortest treatment duration.

19.of the essence (phrase)

English Meaning - to be the most important thing.

20.drag one’s feet (phrase)

English Meaning - delay, procrastinate, postpone action, put off doing something, use delaying tactics, take one’s time.

21.a step in the right direction (phrase)

English Meaning - an action/activity/measure taken that increases someone’s chance or possibility of success.

22.frontline (noun)

English Meaning - the front and most important position.

23.frontline drug (noun)

English Meaning - the most important medicine.

24.tremendous (adjective)

English Meaning - very great, huge, immense, massive, substantial.

25.make sense (phrase)

English Meaning - be accepted, be convincing, hold up, prove true.

26.last (verb)

English Meaning - continue, go on, carry on, take.

27.up to (phrase)

English Meaning - until.

28.undoubtedly (adverb)

English Meaning - obviously, unquestionably, certainly, beyond doubt.

29.admirably (adverb)

English Meaning - desirably, attractively, excellently.

30.commitment (noun)

English Meaning - responsibility, onus, accountability, obligation, liability.

31.political will (noun)

English Meaning - political desire/intention; administrative will.

32.see the back of (phrase)

English Meaning - be rid of; to be freed from or to be relieved of (something unwanted).

33.measure (noun)

English Meaning - action, step, move, procedure.

34.in aid of (phrase)

English Meaning - in support of.

35.conventional (adjective)

English Meaning - traditional, standard, typical, regular, common.

36.culture testing (noun)

English Meaning - a laboratory test to check for bacteria or other germs in a blood sample.

37.drug sensitivity testing (noun)

English Meaning - It determines which drugs can kill the tubercle bacilli. If the tubercle bacilli can be killed by a particular drug, they are susceptible to that drug. If tubercle bacilli can grow in the presence of a particular drug, they are resistant to that drug. (Tubercle bacillus is a bacterium of the genus Mycobacterium (M. tuberculosis) that causes tuberculosis in humans).

38.rapid molecular test (noun)

English Meaning - It facilitates early and accurate detection of people with TB, contributing to improved patient outcomes and reduced disease transmission.

39.diagnose (verb)

English Meaning - identify the nature and cause of an illness/condition by examination.

40.Ni-kshay Mitra (noun)

English Meaning - This is an initiative under the “Pradhan Mantri TB Mukt Bharat Abhiyan (PMTBMBA), implemented by the Ministry of Health & Family Welfare that seeks to eliminate TB by 2025 - five years ahead of the global goal of 2030. First articulated by the Hon’ble Prime Minister in 2018, “Ni-kshay Mitra” is an initiative that provides for additional diagnostic, nutritional, and vocational support by elected representatives, corporates, organisations, NGOs, and individuals to those undergoing TB treatment. This in turn, would help them on their journey towards a successful recovery.

41.yield (noun)

English Meaning - give, provide, produce.

42.incidence (noun)

English Meaning - It refers to the number of new cases that develop in a given period of time whereas “prevalence” refers to the number of cases of a disease that are present in a particular population at a given time.

43.World Health Organization (WHO) (noun)

English Meaning - Founded in 1948, WHO is the United Nations agency that connects nations, partners and people to promote health, keep the world safe and serve the vulnerable - so everyone, everywhere can attain the highest level of health.

44.mortality (noun)

English Meaning - (in a particular time/for a cause) the rate/number of death; death, loss of life.

45.DOTS therapy (noun)

English Meaning - a method of drug administration in which a health care professional watches as a person takes each dose of a medication. Directly observed therapy (DOT) is used to ensure the person receives and takes all medications as prescribed and to monitor response to treatment. DOT is widely used to manage tuberculosis (TB) disease.

46.revolutionise (verb)

English Meaning - transform, alter dramatically, shake up, restructure, reorganize, rejig, reform, recast, reshape.

47.back in the day (phrase)

English Meaning - used to refer to an earlier time; used for talking about a time in the past.

48.administer (verb)

English Meaning - dispense, provide, give, apply (a drug/vaccine).

49.administration (noun)

English Meaning - the way by which a drug (medicine) is taken into the body.

50.supervised administration (noun)

English Meaning - supervised administration of drugs in the presence of trained staff ensures compliance and improves drug regime success rate. Trials across different countries have established the effectiveness of directly observed therapy (DOT) for prevention of relapses.

51.centre (verb)

English Meaning - focus, concentrate, revolve around.

52.merely (adverb)

English Meaning - only, simply, just.

53.pioneer (noun)

English Meaning - trailblazer, innovator, groundbreaker, pathfinder, spearhead, trendsetter, avant-gardist.