The Indian Council for Medical Research (ICMR) will soon launch a comprehensive research on the genital tuberculosis in women which has been increasing in the country for the last some years. The premier medical research organisation's action comes in the wake of reports that genital tuberculosis is an important cause of morbidity in women in the country contributing to nearly 5 per cent of pelvic infections and one per cent of all gynaecological admissions.
There is a paucity of research in India on genital TB. Keeping in view the high prevalence of the disease and the consequences arising from it, there is a need to engage in research that would address many of the unanswered questions, senior officials in the ICMR said.
Officials said that tuberculosis is a major public health problem in India. Even though pulmonary tuberculosis is the commonest form of presentation, genital tuberculosis is an important cause of morbidity in women in India. Under-diagnosis, mis-diagnosis and over-treatment add to the gamut of problems from which the women are already suffering.
For this purpose, the ICMR has invited research proposals on Female Genital Tuberculosis (FGTB). It will provide funding for the proposals that are determined to be relevant to the specific research topics pertaining to Female Genital Tuberculosis. Any faculty/scientist working in a medical college, research institute, or university, anywhere in the country including government, semi-government and registered bodies, can become part of the research programme.
In the Epidemiology topic, the researchers have to evaluate how reporting and recording of female genital TB can be made an integral part of the RNTCP recording and reporting system and to evaluate trends in case detection of female genital TB making use of data already available within RNTCP TB control programme.
The researchers will also have to determine prospectively the incidence of female genital TB in different communities making use of a uniform diagnostic criteria and the risk factors for developing female genital TB and also the impact of HIV on Female genital TB.
In the diagnosis and management topic, the research will be focused on the development of a marker/assay which could be used to assess bacterial viability and to monitor response of therapy and also the development of a multiplex PCR for direct detection of Mycobacterium tuberculosis and to detect Rifampicin and Isoniazid resistance in clinical samples based on the mutations in the Indian strains.
The research in this topic will also focus on the development of a multiplex PCR for detection of Mycobacteria other than tuberculosis (MOTT) and also to design and develop cost effective automation systems for high volume sample handling in molecular diagnostic tuberculosis laboratory with protocols specific for genital specimens.
The researchers will have to develop and evaluate new diagnostic algorithm(s) using all available inputs (clinical signs, physical examination, radiology and ultra sound, microbiology and molecular biology) for diagnosis of FGTB. Which combination of tests is required to make a definite diagnosis of FGTB.
Research will also be done on optimum duration of therapy for treatment of FGTB and need for repeat tests (eg. Endometrial biopsy or imaging method) before stopping the treatment, contribution of liquid based culture in improving the diagnostic yield of the pathogen in suspected cases of FGTB and contribution of Quantiferon Gold TB IT in resolving the diagnostic dilemma.
On the pregnancy and genital tuberculosis topic, research has to be done on: diagnostic delay--effects on fertility outcome; on identify optimum time interval between completion of therapy and plan for pregnancy; and clinical, biochemical, & imaging indicators for suboptimal pregnancy outcome and interventions to improve the perinatal outcome.