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Indian study shows whole-genome sequencing key to detect drug-resistant TB early

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New Delhi, April 16 (IANS) With India aiming to eliminate tuberculosis (TB) by 2025, five years ahead of the global target, whole-genome sequencing (WGS) may play a significant role in identifying cases of drug-resistant TB early and improving outcomes, reveals a study on Tuesday.

Tuberculosis stands as the second leading infectious disease killer globally, with over 2.95 million active cases reported in 2020 alone in India. Of these, 135,000 were classified as multidrug-resistant TB cases.

The study by HaystackAnalytics, an IIT-Bombay startup, in collaboration with Dr. D.Y. Patil Medical College, Pune, is based on data from 600 patients with drug-resistant TB in India.

Data gathered using the WGS method revealed that pre-extensively drug-resistant TB (pre-XDR-TB) was present in 50.83 per cent of cases, while multidrug-resistant TB (MDR-TB) was found in 15.5 per cent, with nearly equivalent proportions among men and women.

These patients were not only resistant to rifampicin — a drug used to manage and treat diverse mycobacterial infections –, and isoniazid — an antibiotic indicated in the first-line treatment of active Mycobacterium tuberculosis (TB) infection –, but also to fluoroquinolones — which is used widely as therapy for respiratory and urinary tract infections, the researchers said.

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“I believe, going forward, whole-genome sequencing might become the first among many tests, which will be prescribed to all TB patients, not only in India, everywhere else in the world,” Dr. Anirvan Chatterjee, CEO and Co-founder at HaystackAnalytics, told IANS.

“WGS is the new gold standard for TB diagnosis and is the way forward for the world for eliminating TB cases,” he added.

Further, the study showed that 55 per cent of people between 15-35 years of age and 67 per cent up to 14 years of age had pre-XDR TB.

“Indeed younger people are getting tuberculosis, which is a cause of concern because this is a productive age group and TB is highly detrimental to the young population,” Anirvan said.

“In fact, there is a lot of drug resistance in the younger age group, which is of very high concern, for reasons of productivity,” he said, noting that it also increases the risk of active transmission of drug-resistant TB.

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He explained that “WGS can find drug resistance to 18 antibiotics in a single test,” eliminating the need for multiple tests

“If this is available or is sought for when the earliest signs of tuberculosis occur, then the therapy will be shorter. It will also improve the outcome. If the right antibiotic is given to a person, transmission reduces by more than 90 per cent, which means that we will be able to reduce new TB cases. And that is the holy grail,” the doctor told IANS.

–IANS

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Developing countries in Asia-Pacific still report high TB cases: ADB

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Manila, July 6 (IANS) Many developing countries in the Asia-Pacific region, including the Philippines, still have a high tuberculosis (TB) incidence rate, according to an article published in the Asian Development Blog of the Asian Development Bank (ADB).

Citing World Health Organization (WHO) data, the recently published article said the highly infectious disease “remains rife” in the region, with Southeast Asia responsible for 46 per cent of global infections in 2022, “the highest in any region”, Xinhua news agency reported.

The article also said the pandemic devastated national TB prevention and treatment programmes, causing an estimated half a million excess deaths between 2020 and 2022.

However, the good news is that there has been a post-pandemic recovery in the number of people diagnosed with and treated for TB, helping to reduce the damage done by the pandemic, it added.

According to the WHO Global Tuberculosis Report 2023, the Philippines, along with Indonesia, Mongolia, Papua New Guinea, and Vietnam, have some of the highest levels of TB in the region — around 700,000 people out of a population of 115 million have active TB.

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Nearly 10 million people in the Philippines reside in impoverished urban areas. Poverty and overcrowding, along with poorly-resourced public health services, are major factors in the widespread incidence of TB in the country, according to The Lancet.

In Indonesia, TB is the fourth-highest cause of death overall, and among those aged 15 to 49 years, it is the number one cause of death by a contagious disease.

TB, an airborne disease spawned by urban poverty, is currently the world’s second-biggest infectious killer after Covid-19. Many countries are working to eliminate TB by 2030, which aligns with the WHO’s End Tuberculosis Strategy.

The article said adapting practices such as mask-wearing and improved hygiene at home and work that proved effective against Covid-19 could play an important role in helping Asia and the Pacific rid themselves of TB permanently.

However, socioeconomic factors, including poverty, overcrowding, poor sanitation, lack of infrastructure, and inadequate public health systems, allow the disease to remain endemic, it added.

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–IANS

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Cut down smoking to avoid cognitive ageing: Study

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New Delhi, July 6 (IANS) Want to maintain sharp memory skills and cognitive function as you age? Cutting down on smoking suggests a large study that found it to be a key lifestyle factor linked to cognitive decline.

The study, published in Nature Communications, is based on a 10-year survey of 32,000 adults aged 50 or over from 14 countries in Europe.

The team led by researchers from the University College London, UK showed that cognitive decline was faster for lifestyles that included smoking. People who smoked had cognitive scores that declined up to 85 per cent more over 10 years than those who did not.

Lead author Mikaela Bloomberg (UCL Behavioural Science & Health) said the study “is observational; it cannot definitively establish cause and effect, but it suggests smoking might be a particularly important factor influencing the rate of cognitive ageing”.

As per previous studies, people who engaged in more healthy behaviours like regular exercise, and moderate alcohol intake have slower cognitive decline. However, it did not specify whether all behaviours contributed equally to cognitive decline.

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However, the new study showed that among the healthy behaviours, “not smoking may be the most important in terms of maintaining cognitive function”.

Among those unable to stop smoking, the study suggests engaging in other healthy behaviours such as regular exercise, moderate alcohol consumption, and remaining socially active “to offset adverse cognitive effects”, Mikaela said.

–IANS

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Surging dengue cases in K'taka: BJP urges Cong govt to declare medical emergency

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Bengaluru, July 6 (IANS) The BJP in Karnataka has demanded that the Congress government declare a medical emergency over the rising dengue cases in the state.

Addressing a joint press conference at the BJP headquarters in Bengaluru, BJP MP C.N. Manjunath demanded that along with declaring a medical emergency, the state government should also form a task force and take the opinion of experts in handling the situation.

“Dengue is detected more among children and it is increasing every day. Six to seven deaths have been reported so far and more than 7,000 active dengue cases are reported in the state. Every day 600 to 700 dengue cases are reported in the state.”

“More cases are reported in Bengaluru, Chikkamagaluru, Mysuru and Hassan. A doctor has succumbed to dengue fever,” Manjunath said.

“Once complications start in dengue, death is 99 per cent as there is no treatment. Controlling dengue is nothing but controlling mosquitoes. The medicines would be administered for fever and blood pressure,” he added.

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“Along with dengue, mosquitoes will also infect people with Zika virus and Chikungunya. Dengue should be declared as an endemic as it has affected people all over the state. The war-footing approach, like how things moved during Covid-19, is needed to tackle the spread of dengue, hence there is a need to declare a medical emergency,” the BJP MP said.

Manjunath also added that the growth of mosquitoes is not coming under control as the construction of flyovers, underpasses and bridges have not been completed on time.

“The land is dug and water is filled and it is becoming a breeding ground for Aedes aegypti mosquitoes known as primary transmitters of dengue fever.”

State BJP Spokesperson C.N. Ashwath Narayan said: “Dengue is spread in all districts. It is a seasonal disease and the Congress government has failed to take precautions. Health Minister Dinesh Gundu Rao is busy touring the state and engaged with party-related activities.”

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The Union government had issued a circular on precautions to be taken by the states after dengue cases were reported from Maharashtra, he added.

“Minister Gundu Rao is not at all focused on the rising number of cases of dengue fever in the state. The private hospitals and laboratories are charging exorbitant rates for blood tests from Rs 1,000 to 1,500, violating all guidelines by the government in this regard,” he said while criticising the Karnataka government.

–IANS

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'Will affect lakhs of honest students': Centre opposes cancellation of NEET-UG exam in SC

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New Delhi, July 5 (IANS) The Centre, in a preliminary affidavit filed before the Supreme Court on Friday opposed the batch of pleas seeking cancellation of the NEET-UG examination, for admission in undergraduate medical programmes, saying it would affect “lakhs of honest candidates” who appeared in it on May 5.

The Union Ministry of Education said that scrapping the entire exam would seriously jeopardise the interests of the lakhs of honest candidates who attempted the question paper held on May 5 this year.

“In the absence of any proof of any large-scale breach of confidentiality in a pan-India examination, it would not be rational to scrap the entire examination and the results already declared. It is submitted that in any examination, there are competing rights that have been created whereby the interests of a large number of students who have taken the examination without adopting any alleged unfair means must not also be jeopardised,” the affidavit said.

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As regards the alleged instances of irregularities, including cheating, impersonation, and malpractices, the Central Bureau of Investigation (CBI) is undertaking an investigation and has taken over the cases registered in different states, it added.

The Centre said that it is committed to conducting all competitive examinations in a fair and transparent manner and if at the behest of some criminal elements, the confidentiality of competitive examinations has been breached, they must be dealt with sternly and with the full force of law to ensure that they are punished.

“The Government is committed to ensure the sanctity of examinations and protect the interest of students. To ensure transparency, fairness, and credibility in public examination, Parliament has enacted the Public Examination (Prevention of Unfair Means) Act, 2024 on 12.02.2024. The Act was brought into effect on 21.06.2024 and provides for stringent punishment for offences related to unfair means in public examinations. Public Examination (Prevention of Unfair Means) Rules, 2024 under the Act have also been notified on 23.06.2024,” it said.

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Recently, the top court had expressed reservations over the filing of a writ petition by a coaching institute alleging irregularities in the conduct of the NEET-UG exam.

“What fundamental rights of yours are violated to enable you to maintain a writ petition filed under Article 32 of the Constitution?” a vacation bench had asked the senior counsel representing Xylem Learning, a coaching institution providing assistance to NEET students.

Meanwhile, President Droupadi Murmu, in her address to a joint sitting of Parliament, asserted that the government was committed to a fair investigation and ensuring strict punishment to the guilty in the instances of paper leaks.

“Even earlier, we have witnessed many instances of paper leaks in different states. It is important that we rise above party politics and undertake concrete measures nationwide. Parliament has also enacted a strict law against unfair means in examinations,” she added.

The Supreme Court is slated to hear on July 8 the batch of petitions pertaining to the NEET-UG exam, including its cancellation.

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–IANS

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Study shows how cancer evades chemotherapy, finds mechanism to reverse

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New Delhi, July 5 (IANS) An international team of researchers from the UK and China has shown how cancer builds up resistance to chemotherapy — one of the biggest challenges in the treatment of the deadly disease.

Using a mice study, the early-stage research, led by The Institute of Cancer Research (ICR), London, and Sun Yat-sen University, China showed that Stiripentol — a drug currently used to treat epilepsy — can help reverse cancer’s resistance to chemotherapy, which will help shrink tumours and prolong survival.

In the study, the team zeroed in on lactate — the product that builds up as cancer cells convert nutrients to energy — which was found to be most abundant in chemotherapy-resistant cancer tissues.

For the study, published in the journal Nature, the researchers examined tissue from 24 patients with stomach cancer, where 15 of the cancers were resistant to chemotherapy and the tumours had continued to grow.

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Stiripentol and chemotherapy reduced the size of tumours — for four weeks after treatment — in mice with stomach cancer. These also survived for longer — for more than 70 days.

In comparison, tumours in mice treated with chemotherapy alone shrunk for one week and started to grow again. With only chemotherapy, no mice survived for longer than 40 days after treatment.

Further, lactate was also found responsible for altering the structure of a key protein involved in DNA repair, called NBS1, and affecting its efficiency.

The researchers believe that lactate may be behind chemotherapy resistance in other cancers such as “pancreatic, lung and ovarian cancers”.

“This extremely promising research has uncovered a likely mechanism for how cancer evades chemotherapy,” said Professor Axel Behrens, Professor of Stem Cell Biology at The Institute of Cancer Research.

“In our early-stage study, we’ve seen that you can prevent the build-up of lactate and make a tumour that was resistant to chemotherapy sensitive again — the treatment continues to work,” Axel added.

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–IANS

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