STRUGGLING WITH the growing Multi-Drug Resistant (MDR) Tuberculosis cases, India is now on the threshold of Extreme Drug Resistant (XDR) TB — virtually, an untreatable form of tuberculosis – that is worrying several other developing countries too.
Though, proper statistical data of XDR-TB patients in India is yet to be collected, experts feel the number could be anywhere between 1 and 2 per cent of the total MDR-TB patients.
“The number of MDR-TB patients according to the World Health Organization is around 15 per cent of those who quit treatment for TB mid-way. Keeping in view the number of MDR-TB cases, it is assumed that 2 per cent of these could be patients of untreatable XDR-TB,” said Dr Rajendra Prasad the advisory board member of the Central Government committee on XDR-TB.
Unfortunately, research scientists are yet to come up with medicine for XDR-TB. Therefore, it is time to focus on Directly Observed Treatment short course (DoTs) programme and restrict the new form of TB, he said.
India presently has over 33,94,040 TB patients and on an average, several lakh new cases are reported every year. There have been 30 deaths per 1,00,000 persons because of TB over the past years while the Smear Positive Treatment Success rate has been 86 per cent in India, which puts India among the top-five nations fighting against TB.
“To control the XDR-TB patients’ number, India is going for a DoTs plus programme from March 2007. Keeping in view the number of MDR-TB patients the focus would be to ensure full coverage of TB patients through the DoTs programme only,” said Dr Prasad who was involved in framing a programme for XDR-TB for the country.
Head of the Pulmonary Disease Medicine at King George’s Medical University, Dr Prasad recently participated in the task force meeting in New Delhi where the blueprint for the XDR-TB programme were announced.
He suggested that the government should support free second line drugs to those medical colleges where there are accredited microbiology labs. This would help in quality culture and susceptibility tests to manage MDR-TB.
“If measures are not taken there could be emergence of XDR-TB which is untreatable using the presently available anti-tubercular drugs,” Dr Prasad said.
The pilot project for XDR-TB would begin from Gujarat and Maharastra. These are the states where the DoTs was first launched in the country thus, the government has decided to launch the XDR-TB programme too from these two states. After observing the success of the programme, the methods would then be applied in other states and the first state to be covered in the second phase could be Uttar Pradesh.
A simple TB treatment lasts for six-eight months and costs around Rs 2,000 and for MDR-TB it is Rs 1,00,000. For XDR-TB the cost is still to be decided.