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World TB Day: 21% hike in drug-resistant cases in Mumbai

MDR TB cases are difficult to treat as patients do not respond to two of the most powerful first line anti-TB drugs.

mumbai Updated: Mar 24, 2017 12:10 IST
Aayushi Pratap
Nurses from different hospitals take part in a rally on the World Tuberculosis Day at Mulund in Mumbai.
Nurses from different hospitals take part in a rally on the World Tuberculosis Day at Mulund in Mumbai.(Pratik Chorge/HT)

As today is marked as World Tuberculosis Day , the Brihanmumbai Municipal Corporations’s (BMC) public health department released a report on the growing health problem in the city that showed a 21% rise in the number of multi-drug resistant (MDR) TB cases in 2016 compared to 2015.

MDR TB cases are difficult to treat as patients do not respond to two of the most powerful first line anti-TB drugs Isoniazid and Rifampicin. This makes the treatment longer and results in higher mortality.

A total of 4,347 cases of MDR TB cases across public and private hospitals were reported by the BMC in 2016, compared to 3,608 cases in 2015.

A rangoli drawn by nurses on World Tuberculosis Day. (Praik Chorge/HT)

Among fresh cases, there was an 8% increase in drug sensitive cases, which are relatively easier to treat as the first-line drugs work. Out of 42,115 drug sensitive cases, 8.9% were paediatric cases.

Civic authorities said the cases have hiked as people have been made more aware about the disease and more private hospitals have reported about the number of cases they saw. There was a 75% increase on TB reporting from private facilities in 2016.

However, Dr Imran Farooq, deputy director (TB) with PATH, an international NGO that has been working with the BMC to improve reporting from private facilities since 2013, said close to 30% cases from private facilities still go unreported. “These are patients, if go undiagnosed, could continue to spread infection in the community,” he said.

Meanwhile, city doctors emphasised on the need to fast-track the introduction of new anti-drugs for extensively drug-resistant tuberculosis (XDR-TB). In these patients, the first and second line drugs which are a cocktail of 12 medicines are ineffective. Dr Zarir Udwadia, who is treating an 18-year old girl with DRTB from Patna, with novel Bedaquiline and Delamanid drug combination, said, thousands of Indian patients who are ‘therapeutically destitute’ need this combination. “When will the government introduce these drugs? They should responsibly roll them out to those who are dying in the want of them,” he said.

Access to Bedaquline in India is strictly regulated, with only six government centres, two in Delhi and one each in Mumbai, Ahmedabad, Guwahati and Chennai, provide the drug to local patients.

While Delamanid is not available through the government yet, officials from Indian Council of Medical Research said it will be introduced this year. “It is an untested combination, reserved for extreme cases,” Dr Udwadia added. The possible side effects of the combination affect the heart, for which the QT interval on ECG needs to be monitored.

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