Starting in October, the National TB Programme (NTP) in Ghana is set to introduce a new treatment regimen for Multi-Drug Resistant (MDR) tuberculosis care.

This new regimen, endorsed by the World Health Organization (WHO), consists of Bedaquiline, Pretomanid, and Moxifloxacin (BPaLM), and offers patients a shorter treatment duration of six months, as opposed to the previous regimen that spanned nine to 18 months.

Additionally, this updated approach will reduce the pill burden on patients, shifting from the current requirement of seven groups of medicines with over 14 tablets to just three medicines daily.

The decision to implement this new regimen was made after the National TB Advisory Board expressed satisfaction with the WHO's implementation plan. This approval came through the Ghana Health Service, facilitated by its implementing body, the TB Programme.

The Programme Manager for NTP, Dr. Yaw Aduse-Poku, informed the Ghana News Agency (GNA) in an interview that the newly recommended BPaLM regimen promises better treatment outcomes, notably shortening the treatment duration and substantially enhancing the quality of life for individuals dealing with MDR/RR-TB.

To initiate the plan, the Programme intends to hold national, regional, and district consultations, seeking external technical assistance to devise a tailored implementation approach for the country. The drugs, Dr. Aduse-Poku mentioned, are expected to arrive in the country by September 30, 2023.

He said a national guideline, training manual and desk aide were being developed adding “logistics in terms of the new drugs have been quantified and procured, and they are scheduled to be in country by September 30, 2023.”

Dr. Aduse-Poku clarified that the new WHO DR-TB treatment regimen, which comprises Bedaquiline, Pretomanid, and Moxifloxacin (BPal M), offers a reduction in side effects compared to the old regimen.

The previous regimen was associated with common side effects such as gastritis, vomiting, decreased appetite, peripheral neuropathy, depression, and suicidal tendencies. The new regimen is designed to be less burdensome for patients, their families, and healthcare workers.

According to the World Health Organization (WHO), tuberculosis (TB) ranks among the top 10 causes of death worldwide. In Ghana, it is estimated that approximately 30 individuals lose their lives to TB each day, while 125 people become ill daily due to the disease.

On a global scale, it is estimated that every day, more than 4,000 people succumb to TB, and nearly 30,000 individuals fall ill with TB disease.

“Currently, Ghana has 169 GeneXpert, 79 digital x-rays in 260 districts and there should be deliberate efforts to provide diagnostic tools for TB diagnosis.”

According to the WHO Report, 2022, Ghana recorded 12,000 TB mortality with 45,000 TB incidence with childhood TB recording 6,500 cases.

“The Programme is currently involved in contact tracing, diagnosing and treating Paediatric TB, intensifying case finding in all facilities, embarking on community outreach programmes, actively involved in TB prevention and treatment, as well as embarking on active screening at mining and prisons to increase detection cases in the country,” Dr Aduse-Poku noted.

Tuberculosis (TB) is primarily transmitted through droplet infection, typically occurring when an individual with TB coughs, sings, or sneezes. Inhalation of these infected droplets by a person without the infection can lead to TB transmission.

While TB commonly affects the lungs, it can also impact other organs within the body, including the pleural cavity, liver, scrotum, kidney, intestines, and womb, a condition referred to as extrapulmonary tuberculosis. Furthermore, TB can affect animals like cattle, known as bovine TB.

TB presents with various symptoms, including cough, weight loss (particularly seen as poor weight gain in children), fever, fatigue, night sweats, chest pain, and coughing with blood-stained sputum. It's important to note that TB is both preventable and curable. Diagnosis and treatment for TB are readily available at no cost in all public and accredited private healthcare facilities.