Context and Background
- Tuberculosis (TB) remains a major public health challenge, with India accounting for 28% of global new TB cases.
- The Dare2eraD TB initiative was launched in 2022 under the Department of Biotechnology (DBT) to sequence 32,500 TB genome samples.
- 10,000 samples (one-third of the target) have been sequenced so far, with full sequencing expected by October 2025.
- This initiative aligns with India’s target to eliminate TB by 2025, set at the 2018 End TB Summit, ahead of WHO’s 2030 target.
- Genome sequencing aims to:
- Identify drug–resistant TB strains.
- Capture unique genetic features of Mycobacterium tuberculosis in India.
- Improve diagnostics and treatment strategies using AI-powered analysis.
Relevance : GS 2(Health) ,GS 3(Science )
Key Findings from Sequenced Samples
- 7% of sequenced TB cases show resistance to a single drug, highlighting the growing challenge of drug-resistant TB (DR-TB).
- Age Profile: Majority of TB cases are in the 18-45 years age group, indicating a high burden among the working population.
- Comorbidities: Many TB patients were also diabetic and underweight, reinforcing the link between nutrition, metabolic disorders, and TB susceptibility.
- Prevalence: India had 1,990 cases per million in 2022, down from 2,370 per million in 2015, but still far from the 1 per million ‘elimination’ benchmark set by WHO.
- Latent TB Reservoir: The number of undiagnosed, asymptomatic TB carriers could be as high as 3,000 per million, contributing to continued transmission.
Impact and Implications
- Better TB Diagnostics & AI Integration
- Genome sequencing data, combined with AI models, can help reduce TB diagnosis time from three weeks to one week.
- Faster identification of drug-resistant strains will improve treatment protocols.
- Personalized Medicine & Targeted Therapy
- Understanding genetic variations in TB bacteria will aid in the development of region-specific drug treatments.
- Potential to develop genome-based rapid diagnostic kits.
- Public Health Policy & TB Eradication Strategy
- Data-driven approaches will help in better allocation of resources to high-TB-burden areas.
- Policy interventions needed to address nutrition and diabetes as risk factors for TB.
- Challenges in TB Eradication
- Eliminating TB by 2025 is highly ambitious, given current prevalence rates.
- The presence of latent TB cases means transmission will continue unless preventive treatment strategies are expanded.
- Multidrug-resistant TB (MDR-TB) poses a major challenge due to limited treatment options and higher costs.
Causes and Factors
- Delayed Diagnostics & Inconsistent Testing
- Traditional TB detection methods (sputum tests, X-rays) take weeks and may not detect drug-resistant strains early.
- Limited availability of advanced molecular diagnostic tools in rural India.
- Drug-Resistant TB Evolution
- Inadequate TB treatment adherence leads to MDR-TB, where bacteria develop resistance to key antibiotics like Rifampicin and Isoniazid.
- Self-medication, improper prescriptions, and interrupted treatments contribute to resistance.
- Nutritional & Metabolic Linkages
- High TB burden among diabetics and underweight individuals suggests a nutritional and metabolic component in susceptibility.
- Poor access to balanced diets and healthcare in rural areas exacerbates TB risks.
- Urbanization & Migration Patterns
- Overcrowding in urban slums and migrant worker clusters increases TB transmission rates.
- Inconsistent access to healthcare among migrant populations reduces early TB detection and treatment compliance.
Way Forward
- Strengthen Genome-Based TB Surveillance
- Expand TB genome sequencing efforts beyond 32,500 samples for wider genetic mapping.
- Integrate genome data into national TB control programs for better tracking of resistant strains.
- Enhance AI-Powered Diagnostic Tools
- Machine learning models should be developed to analyze genome data and predict drug resistance trends.
- Promote the use of faster and portable genome-based diagnostic kits at primary health centers.
- Scale Up Preventive & Early Treatment Measures
- Mass screening programs targeting high-risk groups (diabetics, undernourished, urban slums).
- Expand access to preventive therapy for latent TB cases.
