印度消除结核病:国家现状

Angeline Grace G, Sujitha P
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摘要

结核病(TB)仍然是印度公共卫生面临的重大挑战,印度是全球结核病例负担最重的国家。本文概述了印度正在为消除结核病所做的努力,重点介绍了所取得的进展和持续面临的挑战。印度于 1997 年启动了修订后的国家结核病控制计划(RNTCP),该计划在结核病控制方面取得了显著进展。RNTCP 的推出以及后来在 2017 年扩展为国家消除结核病计划(NTEP),旨在加强诊断和治疗服务,重点是实现结核病护理的普及。短期直接观察治疗(DOTS)疗法一直是治疗的基石,有助于显著降低结核病死亡率。近年来,印度在采用分子诊断和远程医疗等新技术以加强结核病病例检测和患者护理方面取得了长足进步。治疗耐药性结核病的新型药物 Bedaquiline 和 Delamanid 的问世,为耐药性较强的结核病患者带来了希望。然而,印度在消除结核病的道路上并非没有挑战。当务之急是改善医疗基础设施,减少耻辱感,提高公众和医疗服务提供者的意识。耐药性结核病的出现以及 COVID-19 大流行对结核病防治服务的影响也带来了更多障碍。印度在消除结核病的道路上既取得了重大进展,也面临着持续挑战。为了实现到 2025 年消除结核病的宏伟目标,需要共同努力加强医疗保健系统、提高诊断能力并解决该疾病的社会决定因素。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
Tuberculosis Elimination in India: Where the Country Stands
Tuberculosis (TB) remains a significant public health challenge in India, with the country bearing the highest burden of TB cases globally. This article provides an overview of India's ongoing efforts towards TB elimination, highlighting both progress and persistent challenges. India's Revised National Tuberculosis Control Program (RNTCP), launched in 1997, has made remarkable strides in TB control. The introduction of the RNTCP and later its expansion as the National Tuberculosis Elimination Program (NTEP) in 2017, aimed to strengthen diagnostic and treatment services, with a focus on achieving universal access to TB care. DOTS (Directly Observed Treatment, Short-course) therapy has been a cornerstone of treatment, contributing to significant reductions in TB mortality. In recent years, India has made strides in adopting new technologies, including molecular diagnostics and telemedicine, to enhance TB case detection and patient care. The introduction of Bedaquiline and Delamanid, novel drugs for drug-resistant TB, has offered hope for patients with more resistant forms of the disease. However, the road to TB elimination in India is not without challenges. There is a pressing need for improved healthcare infrastructure, reduced stigma, and increased awareness among both the public and healthcare providers. The emergence of drug-resistant TB and the impact of the COVID-19 pandemic on TB services have posed additional hurdles. India's journey toward TB elimination is marked by significant progress and continued challenges. To achieve the ambitious goal of eliminating TB by 2025, concerted efforts are required to strengthen healthcare systems, improve diagnostic capabilities, and address social determinants of the disease.
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