The treatment of bone and spinal tuberculosis poses unique challenges due to the difficulty of administering antibiotics to the infected area.
Tuberculosis remains among the top 15 killer diseases today, killing 1.7 million people each year. More than 10 million new cases are recorded each year. According to a report by the World Health Organization, this disease is an infectious killer second only to COVID-19. On World Tuberculosis Day today, the World Health Organization (WHO) announced the expansion of the scope of the WHO Director-General’s (DG) Flagship Initiative on tuberculosis from 2023 to 2027. This is done to accelerate progress towards eliminating tuberculosis. and achieve universal health coverage (UHC) by 2030. To this end, the UN General Assembly also plans to convene three high-level meetings in September this year. The focus of these meetings will be on universal health coverage, pandemic preparedness and response, and eradication of tuberculosis.
The theme for this year’s World TB Day is #WeCanEndTB. India’s health sector is well aligned with this theme as it works hard to realize Indian Prime Minister Narendra Modi’s dream of eliminating TB by 2025. India has achieved the global SDG target to end tuberculosis by 2025. In India, tuberculosis is a widespread disease. infectious disease. According to the WHO World Tuberculosis Report 2022, India has about 3 million new TB cases and over half a million TB deaths. Among these cases, bone and vertebral tuberculosis constitute a significant proportion, accounting for about 1-2% of all tuberculosis cases in the country. To better understand bone and vertebral tuberculosis, we contacted Dr. Vikas Tandon, Sr. Consultant – Spine Surgeon, Indian Spinal Injuries Center. He shares his view in the following words.
Cause of Bone and Vertebral Tuberculosis
Bone and vertebral tuberculosis, also known as bone and joint tuberculosis, occurs when the bacterium Mycobacterium tuberculosis infects the bones and joints. The disease primarily affects the spine, causing a condition called Pott’s disease. It can also affect the long bones of the limb, hip and knee joints. The incidence of bone and spinal tuberculosis in India is high, mainly due to the country’s large population, poor sanitation and insufficient access to healthcare. The disease is most prevalent in rural areas, where access to medical care is limited and people often live in overcrowded and unsanitary conditions.
Tuberculosis eradication by 2025: is it possible?
It is evident that the number of new TB patients decreased by 18% between 2015 and 2021 in India, but this rate of decline is clearly not enough to end TB by 2025. A typical example is the Indian Spine Injury Center where we are witnessing a decline as the total number of TB cases was 200 males and 175 females in 2021 while it decreased in 2022 to 152 males but increased in females from 236 cases. The total number of cases of spinal tuberculosis in 2021 was 80 (males) and 66 (females). In 2022, while there was a decline in men at age 65, the number of cases in women increased to 94. Similarly, in 2021, there were 10 cases of bone tuberculosis in men and 4 cases in women. In 2022, the total number of bone tuberculosis cases fell to 5, but the number of female cases remained at 4. The trend clearly indicates that women are more at risk.
Treatment Options
Treatment for Bone and Spine Tuberculosis in India is similar to that for other Tuberculosis infections. It is a combination of antibiotics taken over a period of six to nine months, with some patients requiring surgery to remove the affected tissue. The treatment of bone and spinal tuberculosis poses unique challenges due to the difficulty of administering antibiotics to the infected area. As a result, doctors often recommend a longer duration of antibiotic therapy, as well as the use of immobilization devices to prevent further damage to affected bones and joints.
In addition to antibiotic therapy, patients with bone and spinal tuberculosis may also need nutritional support to promote healing and reduce the risk of further complications. Follow-up care is essential to monitor the patient’s response to treatment and identify any adverse drug reactions.
Bone and spinal tuberculosis remains a significant public health challenge in India. With better access to health care, sanitation and public education, the incidence of disease can be reduced. Early diagnosis and proper treatment remain the key to successful management of bone and spinal tuberculosis in India.
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