Ending TB in South-East Asia: flagship priority and response transformation.

Over the decades, the global tuberculosis (TB) response has evolved from sanatoria-based treatment to DOTS (Directly Observed Therapy Shortcourse) strategy and the more recent End TB Strategy. The WHO South-East Asia Region, which accounted for 45% of new TB patients and 50% of deaths globally in 2021, is pivotal to the global fight against TB. "Accelerate Efforts to End TB" by 2030 was adopted as a South-East Asia Regional Flagship Priority (RFP) in 2017. This article illustrates intensified and transformed approaches to address the disease burden following the adoption of RFP and new challenges that emerged during the COVID-19 pandemic. TB case notifications improved by 25% and treatment success rates improved by 6% between 2016 and 2019 due to interventions ranging from galvanising political commitments to empowering and engaging communities. Cumulative TB programme budget allocations in 2022 reached US$ 1.4 billion, about two and a half times the budget in 2016. An ambitious Regional Strategic Plan towards ending TB, 2021-2025, identifies priority interventions that will need investments of up to US$ 3 billion a year to fully implement them. Moving forward, countries in the Region need to leverage RFP and take up intensified, people-centred, holistic interventions for prevention, diagnosis, treatment and care of TB with commensurate investments and cross-ministerial and multi-sectoral coordination.

HBeAg/anti-HBe, alanine aminotransferase and HBV DNA levels in HBsAg positive chronic carriers.

Serum samples from a total of 72 chronic hepatitis B virus carriers were analysed by serological, biochemical and molecular assays. The aim was to evaluate the relationship of the serological and biochemical parameters with molecular markers in order to assess the infectivity of virus. Out of 72 chronic HBsAg positive carriers, 28 patients were HBeAg positive and anti-HBe negative, 38 patients were HBeAg negative and anti-HBe positive, only 3 patients were positive for both HBeAg and anti-HBe and the rest 3 patients were negative for both markers. Detectable HBV DNA lcvcl was found in 92.86% HBsAg-positive/anti-HBe negative patients along with raised alanine aminotransferase (ALT) level (67.86%) compared with HBeAg-negative/anti-HBe positive carriers (36.84%) (p value = 0.02) and out a total of 38 HBeAg-negative/anti-HBe positive carriers, 12 (31.58%) patients had detectable lcvel of HBV DNA. Among the 14 HBeAg-negative/anti-HBe positive patients with elevated ALT level, 8 (57.14%) had detectable HBV DNA whereas out of 24 HBeAg-negative/anti-HBe positive patients with normal ALT level only 4 (16.66%) had detectablc HBV DNA lcvel. Significantly high rate of detection of HBV DNA was seen among anti-HBe positive patients with raised ALT level compared with the patients with normal ALT level (p value = 0.01).