An increasing number of patients in the city are contracting the tuberculosis (TB) bacteria which do not respond to the known anti-tuberculosis drugs. Between 2014 and 2015, the municipal corporation saw a 63% increase in the number of patients being diagnosed of extensively drug-resistant tuberculosis (XDR-TB).
In these patients, doctors said that the first and second line drugs which are a cocktail of about 12 medicines are ineffective. Deaths owing to TB during the said period increased by 12% -most people who die of TB have the resistant bacteria.
In fact, around 100 patients in Mumbai in the coming weeks will be enrolled in a country-wide trial to understand the effectiveness of Bedaquiline- the most recently introduced anti-TB drug globally. “The drugs will be given for 24 weeks to drug-resistant patients. We have to see how we respond according to our genetic makeup. The drug may even work better for us,” said Dr Amita Athawle, head of chest medicine department at KEM Hospital. The said drug is available in some developed countries for some time but has been only made available to India now.
Though the civic officials attributed the rise in TB cases to the improvement in testing facilities, the fact remains that the cases continue to rise despite preventive steps undertaken recently. The multi-drug resistant TB where only four of the 12 known anti-TB drugs are effective has also increased marginally during the same period.
Overall, the number of patients detected with TB in the city increased from 31,673 in 2014 to 38,285 last year- a 20% rise. “We have strengthened our testing facility. We have 16 GeneXpert machines which can detect drug-resistant cases. We are going to add four more. Better infrastructure has led to detection of more cases,” said Dr Daksha Shah, city’s TB control officer adding that
To meet the need for hospitalisation for drug-resistant TB patients, the civic body is instituting a special ward at Sarvoday Hospital in Ghatkopar. This is the first time that a treatment facility dedicated to treat drug –resistant patients will be started in a charitable hospital.
Doctors said that one-third patients with drug-resistant TB are known because of the spread from lungs to other organs. “Resistance occurs when patients don’t complete their treatment or when he is treated sub-optimally. Patients who are labelled as XDR-TB cases do not respond to all the known TB drugs and we have to resort to salvage drugs which can often be toxic,” said Dr Om Shrivastav, infectious disease consultant, Saifee Hospital adding that the toxicity should not be more dreadful than the disease.